Tag Archive for: Dvorsky

boy getting vaccinated

Adolescents with ADHD more hesitant to get COVID-19 vaccine

boy getting vaccinatedAdolescents with attention-deficit/hyperactivity disorder (ADHD) report greater hesitancy and less confidence in COVID-19 vaccine safety compared to adolescents without ADHD, a new study finds.

For all adolescents in the study, those who identified as Black or Latino — and came from families with lower income levels — were more likely to be vaccine hesitant and report lower confidence in the safety of COVID-19 vaccines.

Whereas greater COVID-19 concerns, compliance to social distancing guidelines, media use and perceived negative impact of COVID-19 on relationships was associated with greater vaccination willingness.

The study, led by Melissa Dvorsky, Ph.D., director of ADHD & Learning Differences Program at Children’s National Hospital, also highlighted that:

  • Adolescents with ADHD who engage in large gatherings indoors are at greater risk for vaccine hesitancy.
  • Interventions should target social-cognitive processes for adolescent vaccination.

“Adolescents with ADHD being more vaccine hesitant is perhaps in part due to core risk mechanisms associated with ADHD, likely impacting planning, motivation and execution of vaccination, adolescents’ risk appraisal, and perceived susceptibility to COVID-19,” Dr. Dvorsky said. “Our study also found key social mechanisms predicted increased vaccine acceptance and uptake, and these factors should be leveraged in ongoing initiatives addressing vaccine uptake among teens.”

Findings have important implications for health and mental health providers and educational strategies aimed at promoting COVID-19 vaccinations in adolescents.

Earlier this month, Mayor Muriel Bowser and DC Health announced amplified efforts to encourage families to vaccinate youth ahead of the upcoming 2022-2023 school year, sending a message that students must get caught up on vaccinations over the summer. In addition to expanding access to vaccination services, a concerted effort, Dvorsky added, is needed to increase trust, confidence, motivation and social relevance among adolescents. This is especially true for those with ADHD and from lower socio-economic backgrounds.

“As health and mental health care providers, we are uniquely positioned to offer effective communication using strong, presumptive language with all adolescents in our community to address vaccine hesitancy. Adolescents with ADHD, in particular, can benefit from frequent behavioral ‘nudges’ (such as prompts or reminders, automatic appointments) and social/motivational strategies (such as social network interventions, peer-delivered approaches, motivational interviewing) to increase vaccine uptake.”

It’s important to note that research addressing adolescent COVID-19 vaccination willingness and readiness remains scarce.

The study included 196 adolescents (87 male) ages 16-18 from two sites in the Southeastern and Midwestern United States. Participants were high school students in 11th and 12th grade during the 2020-2021 school year. Participants came from a range of socioeconomic backgrounds, with 21% of families falling below the 2019 U.S. median household income ($68,703). Approximately half of the participants were comprehensively diagnosed with ADHD prior to COVID-19.

group of teenagers sitting on a wall

Assessing the pandemic’s impact on adolescents with and without ADHD

group of teenagers sitting on a wall

Understanding factors that foster resilience and buffer against the negative psychological impact of COVID-19 is critical to inform efforts to promote adjustment, reduce risk and improve care, particularly for adolescents with neurodevelopmental disorders.

In a new prospective longitudinal study, Melissa Dvorsky, Ph.D., director of the ADHD & Learning Differences Program at Children’s National Hospital and lead author, and others address this gap by investigating the impact of the COVID-19 pandemic on adolescents’ mental health and substance use, and by assessing specific positive coping strategies among adolescents with and without attention-deficit/hyperactivity disorder (ADHD).

Read the full study in Research on Child and Adolescent Psychopathology.

wooden brain puzzle

Parent engagement in treatment benefits ADHD patients

wooden brain puzzle

Parent engagement in behavior management skills is associated with improvements in child attention, behavior and academic outcomes as well as parenting outcomes, a new study led by Melissa Dvorsky, Ph.D., psychologist at Children’s National Hospital and Director of the ADHD & Learning Differences Program, found.

Parents who frequently use behavior management skills throughout treatment predicts positive parent- and teacher-rated outcomes at the end of treatment. Similarly, parents who continue using these skills after treatment ends predicts improved parent- and teacher-rated outcomes six months later.

The study looks at individual differences in parent engagement in a school-home treatment for children with attention and behavior challenges or attention-deficit/hyperactivity disorder (ADHD). Specifically, Dr. Dvorsky and others found three distinct patterns of the ways in which parents use the behavioral strategies throughout treatment. Parents who increased their use of skills during treatment and had moderate to high adherence by the first few sessions had better parent- and teacher-rated post-treatment outcomes. In other words, they responded better to treatment when experts looked at both child outcomes and parenting. Children had improved behavior, reduced ADHD symptoms and improved academic competence, whereas parents had positive parenting outcomes.

“This study brings to light that there are key differences in how different parents engage in treatment,” Dr. Dvorsky says. “This underscores the importance of supporting families and focusing on strategies that optimize family engagement in treatment given it significantly impacts how well the child responds to treatment.”

With these findings, Dr. Dvorsky says clinicians can identify ways to better engage patients and families in treatment for ADHD, but also for other pediatric conditions too. Families, she says, will experience greater benefits from treatment when they are understanding the skills, engaging in strategies that meet their needs and goals, and practicing skills between sessions.

“Clinicians can now understand the importance of improving treatment engagement and make greater efforts to connect with patients and their families,” she adds. “A greater focus on supporting this treatment engagement is beneficial for patients. I’m hoping to continue this work to study important barriers and facilitators for parent engagement to better understand how we can help patients and families engage in treatment more effectively.”

In order to achieve this, Dr. Dvorsky says this entails a focus on identifying individualized or personalized approaches to match patient’s needs, using adaptive intervention designs and targeting social, emotional and cognitive processes that impact engagement. For youth and families with ADHD, these processes include motivation, social support and executive functioning.