Results indicate that the QbTest may be helpful for the behavioral assessment of childhood ADHD, yet further studies on its psychometric quality and clinical utility are needed.

Background: Treatment for children with attention deficit/hyperactivity disorder (ADHD) today is predominantly pharmacological. While it is the most common treatment, it might not always be the most appropriate one. Moreover, long term effects remain unclear. Behavior therapy (BT) and non-pharmacological treatments such as neurofeedback (NF) are promising alternatives, though there are no routine outpatient care/effectiveness studies yet that have included children with medication or changes in medication.Methods/design: This paper presents the protocol of a randomized controlled trial to compare the effectiveness of a Slow Cortical Potential (SCP) NF protocol with self-management (SM) in a high frequent outpatient care setting. Both groups (NF/SM) receive a total of 30 high frequent therapy sessions. Additionally, 6 sessions are reserved for comorbid problems. The primary outcome measure is the reduction of ADHD core symptoms according to parent and teacher ratings.Preliminary Results: Untill now 58 children were included in the study (48 males), with a mean age of 8.42 (1.34) years, and a mean IQ of 110 (13.37). Conners-3 parent and teacher ratings were used to estimate core symptom change. Since the study is still ongoing, and children are in different study stages, pre-post and follow-up results are not yet available for all children included. Preliminary results suggest overall good pre-post effects, though. For parent and teacher ratings an ANOVA with repeated measures yielded overall satisfying pre-post effects (η2 0.175–0.513). Differences between groups (NF vs. SM) could not yet be established (p = 0.81).Discussion: This is the first randomized controlled trial to test the effectiveness of a NF protocol in a high frequent outpatient care setting that does not exclude children on or with changes in medication. First preliminary results show positive effects. The rationale for the trial, the design, and the strengths and limitations of the study are discussed.Trial registration: This trial is registered in www.clinicaltrials.gov as NCT01879644.

BackgroundIt is well-established that ADHD children have deficits in executive functions such as performance variability and sustained attention. It has been suggested that these deficits are intermediate phenotypes. Hyperactivity, a core symptom of ADHD, has not yet been explored as a potential intermediate phenotype in ADHD. The computerized Quantified behavior Test (QbTest) is a combined continuous performance and activity test that assesses hyperactivity, inattention, and impulsivity separately. The aim of the present study was to (1) investigate the utility of objectively measured motor activity as a potential intermediate phenotype in ADHD, and (2) explore intermediate phenotypes for ADHD at the factor instead of single variable level.MethodForty-five ADHD children, 22 non-affected siblings, and 45 unrelated controls with no family history of ADHD performed the QbTest. Effects of familiality as well as influences of age and gender on QbTest symptom dimensions were tested.ResultsADHD children showed the greatest impairments on all three QbTest factors, followed by their non-affected siblings, with control children showing the lowest scores. Group differences between the non-affected siblings and controls were only significant for the motion tracking-based Hyperactivity factor. Results were independent of age and gender.ConclusionHyperactivity assessed by a motion tracking system may be a useful intermediate phenotype in ADHD. Prospective research should use larger samples to further examine the QbTest factors, especially the motion tracking-based Hyperactivity factor which may be a candidate for an intermediate phenotype in ADHD.

Conners 3 ratings seem to be robust against influences of cultural variation. Their German translation can be utilized for children with Turkish migration background without limitation.