This study evaluated the relationship between noise and academic performance and behavior of children with ADHD (n = 15) and without ADHD (n = 18). Children completed math sheets under four noise conditions: no noise, standard classroom noise, classroom noise with verbalizations, and classroom noise with classical music. There were no differences in math performance between the two groups. Children with ADHD exhibited more problem behaviors than children without ADHD. Group-by-condition interactions were not significant. Significant effects were found for noise condition; children completed more math problems and had fewer inappropriate behaviors in the no-noise condition. However, there were significant order effects with children performing better on the initial task. The no-noise condition was always presented first; other conditions were randomized. Thus, it is impossible to determine if improved performance was due to decreased environmental stimulation or initial performance effects. Implications of these findings are discussed.

Many children and adolescents in the United States experience externalizing behavior problems identified as attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder. These behavior problems cause disruptions in the youth’s socioemotional functioning and academic success. The assignment of a diagnosis from the DSM-5 is often the first step in treatment planning, because many clinics and third-party payers require a diagnosis for authorization of treatment payment. However, research has repeatedly revealed that informants differ in the information they provide regarding youth mental health. While studies have separately examined the association of youth characteristics, parent characteristics, and family characteristics and informant agreement, there is a dearth of research examining the association between these variables in mother-father agreement of ethnically diverse youth. The current study addresses this gap in a sample of 88 mother-father dyads in a clinic sample of youth evaluated for the presence of externalizing behavior problems. Pearson correlations and paired t-tests were run to examine associations and discrepancies, respectively, between mother and father reports of youth inattention, hyperactivity/impulsivity, defiance/aggression, and learning problems. Regression analyses were run to examine the impact of child age, gender, symptom severity, ethnicity, family income, and parent mental health (i.e., depressive symptoms, parenting stress) on mother-father reporting discrepancies. Overall associations between mother and father reports of youth behavior problems were positively correlated, and moderate to large in magnitude. Mother’s depression scores, mother and father parenting stress scores, and child’s symptom severity were significant predictors in some regression analyses. Child age, child ethnicity, father’s depression scores, and family income were not significant predictors in the regression analyses. Results of this research contribute to the small literature base of discrepancies in parent reports in ethnically diverse youth. It further expands upon the minimal research regarding paternal caregivers. Further, it highlights the need for mental health screening of youth’s parents during child psychological assessment to identify situations in which both parent reports may be necessary for appropriate assessment of youth mental health.

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Developmental Dyslexia (DD), Attention Deficit Hyperactivity Disorder (ADHD), and Educational Attainment (EA) are highly prevalent conditions that have a significant impacton individuals' academic and social functioning. These conditions have a complex genetic basis and are often comorbid. To assess the polygenic architecture of these traits, psychiatric genetics researchers utilize a sophisticated tool known as polygenic scores (PGS). By combining numerous genes of individually modest effects, PGS summarizes an individual's genetic risk as a single score. In this study, we aimed to examine the association between PGS for ADHD and EA with typical DD traits. Using a meta-analytic approach, we analyzed data from earlier studies and found that PGS-ADHD accounts for 1.2% of the variance in DD, with a pooled effect size of r = -0.11 (95% CI = [-0.171, -0.050]). Similarly, PGS-EA accounted for 3.2% of the variance in DD, with a pooled effect size of r = 0.18 (95% CI = [0.070, 0.288]). Although these effect sizes are relatively small, it is important to note that PGS are not typically strong predictors on their own, but rather capture a small portion of the genetic variation that contributes to a trait or outcome. My findings suggest that PGS for ADHD and EA are associated with DD, indicating that DD has a complex genetic basis. However, these findings also raise questions about the impact of PGS on psychiatric research moving forward. To address these questions, I provide recommendations for future researchdirections.

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Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavior disorder in children. With the frequency of ADHD diagnoses, primary care providers (PCP) are challenged with managing this chronic and complex concern in an efficient yet effective way, both in terms of time and money. Research indicates behavioral diagnoses and management take approximately five minutes longer than medical-only concerns. This can result in a revenue loss for primary care practices. However, an on- site behavioral health consultant (BHC) can help PCPs provide a high standard of care for children presenting with behavioral concerns without compromising cost effectiveness. This study’s aim was to assess the cost per minute in a small rural primary care practice that utilizes an on-site BHC by comparing data between ADHD appointments when the BHC was utilized versus ADHD appointments when the BHC was not utilized. This study used extant data consisting of a sample of 53 children with ICD-9-CM codes 314.00 or 314.01, indicating an ADHD diagnosis. Of the 53 children with these codes, 40 (75.5%) were billed using E/M codes 99213 or 99214. The first of these indicates a regular office visit with an established patient not exceeding 15 minutes while the latter is used if the visit lasts longer than 25 minutes. Both codes were combined and evaluated together. The database was then recoded to indicate whether or not a BHC was utilized. Using descriptive statistics, it was found that children with ADHD spent a max of 69 minutes (20.19 minutes on average) with the PCP when a BHC was not utilized and a max of 22 minutes (13.67 minutes on average) when a BHC was utilized. Furthermore, an average of $82.79 in insurance reimbursement was received by the practice for these types of visits, regardless of up-coding for physician time spent. Using these statistics, it was determined that the practice makes $4.10 per minute when a BHC is not utilized versus $6.06 per minute when a BHC is utilized for ADHD appointments, due to the time savings ratio. The results indicate that utilization of a BHC increases revenue with respect to minutes spent with the child, while still providing behavioral health time and attention to the patient. These findings have practical implications for the treatment and management of ADHD and support the use of BHCs in pediatric primary care settings. Given the nature of pediatric primary care, it would be more cost effective for PCPs to utilize an on-site BHC with all ADHD visits.

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