title: ADHD and secondary ADHD criteria fail to identify many at-risk survivors of pediatric ALL and brain tumor.
abstract: BACKGROUND
  Post-treatment attention problems experienced by pediatric cancer survivors have been described as similar to symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) experienced in physically healthy children. Accordingly, the objectives of this study were to: (a) estimate the rate of occurrence of ADHD and secondary ADHD (SADHD) in a sample of pediatric cancer survivors, (b) compare the rate of ADHD/SADHD among survivors to the prevalence of ADHD in the general population, and (c) examine clinical correlates of ADHD/SADHD in this sample.
  
  
  METHODS
  Survivors of pediatric ALL or brain tumor (n = 100) participated in an assessment of attention including a Computerized Performance Measure [Conners' Continuous Performance test-II (CPT-II)], parent and self-report measures (Conners 3), and a structured diagnostic interview for ADHD and other psychological disorders [Diagnostic Interview for Children and Adolescents-IV (DICA-IV)].
  
  
  RESULTS
  Binomial tests revealed that the rate of ADHD/SADHD in our sample (9%) was significantly greater than the lower limits of ADHD prevalence among children in the US (3%; P < 0.001), while no difference was identified compared to the upper limits of ADHD prevalence (7%; P > 0.05). Many additional survivors (>25% of the sample) obtained clinical elevations on Conners 3 scales but did not meet ADHD/SADHD criteria.
  
  
  CONCLUSIONS
  Attentional deficits experienced by pediatric cancer survivors do not appear to resemble the clinical presentation of ADHD or SADHD. Many survivors with cognitive and behavioral difficulties related to attention were not identified using this diagnostic approach. Findings offer needed clarification to guide researchers and clinicians in conceptualizing, assessing, and intervening on attentional late effects.
authors.affiliation: Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston, Texas, USA. lskahall@texaschildrens.org
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Kahalley
authors.forename: Heather M
authors.initials: HM
authors.lastname: Conklin
authors.forename: Vida L
authors.initials: VL
authors.lastname: Tyc
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Wilson
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Hinds
authors.forename: Shengjie
authors.initials: S
authors.lastname: Wu
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Xiong
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D001932:Brain Neoplasms / Q000150:complications / Q000401:mortality* / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000401:mortality* / Q000628:therapy; D014481:United States / Q000453:epidemiology