Alice Charach's research while affiliated with University of Toronto and other places

Publications (77)

Article
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Objectives Canadian province-wide lockdowns have challenged children’s mental health (MH) during the COVID-19 pandemic, with autistic children being at particular risk. The purpose of our study was to identify sub-groups of autistic children with distinct mental health change profiles, to understand the child-, parent-, and system-specific factors...
Preprint
Importance Heterogeneous mental health outcomes during the COVID-19 pandemic are recognized in the general population, but it has not been systematically assessed in youth with neurodevelopmental disorders (NDD), including autism spectrum (ASD). Objective Identify subgroups of youth with ASD/NDD based on the pandemic impact on symptoms and service...
Article
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This large cross-sectional study examined the impact of COVID-19 emergency measures on child/adolescent mental health for children/adolescents with and without pre-existing psychiatric diagnoses. Using adapted measures from the CRISIS questionnaire, parents of children aged 6–18 (N = 1013; 56% male; 62% pre-existing psychiatric diagnosis) and self-...
Article
Introduction: The COVID-19 pandemic has impacted the mental health (MH) of children, adolescents and parents. Whereas youth with MH disorders and neurodevelopmental disorders (NDD) may be at higher risk for exacerbations in emotional and behavioural distress, children and adolescents without pre-existing MH disorders or NDD may also experience MH...
Article
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Importance Longitudinal research on specific forms of electronic screen use and mental health symptoms in children and youth during COVID-19 is minimal. Understanding the association may help develop policies and interventions targeting specific screen activities to promote healthful screen use and mental health in children and youth. Objective To...
Preprint
Background: Digital media screens have become an essential part of our family life. While most studies focus on children’s screen use, we know less about parental screen use patterns and how these affect children’s socio-emotional development.Method: 867 Canadian parents of 5-year old children from the TARGet Kids! Cohort (73.1% mothers, mean age=3...
Article
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We examined pathways from pre-existing psychosocial and economic vulnerability to mental health difficulties and stress in families during the COVID-19 pandemic. Data from two time points from a multi-cohort study initiated during the COVID-19 pandemic were used. Parents of children 6-18 years completed questionnaires on pre-COVID-19 socioeconomic...
Article
Primary Subject area Public Health and Preventive Medicine Background Various studies have examined the general impact of the COVID-19 outbreak on children’s health behaviours. The impact of public health measures practised by children during COVID-19 is relatively unknown. Objectives The primary objective was to determine the association between...
Article
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Objective The primary objective was to determine the association between public health preventive measures and children’s outdoor time, sleep duration, and screen time during COVID-19. Methods A cohort study using repeated measures of exposures and outcomes was conducted in healthy children (0 to 10 years) through The Applied Research Group for Ki...
Article
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Introduction Transition from child and adolescent mental health services (CAMHS) to community or adult mental health services (AMHS) is a highly problematic health systems hurdle, especially for transition-aged youth. A planned and purposeful transition process is often non-existent or experienced negatively by youth and their caregivers. Stakehold...
Article
Over the last year, the coronavirus disease 2019 (COVID-19) pandemic has resulted in profound disruptions across the globe, with school closures, social isolation, job loss, illness, and death affecting the lives of children and families in myriad ways. In an Editor's Note in our June 2020 issue,our senior editorial team described this Journal's ro...
Article
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Background Although research on the relationship between parent and child mental health is growing, the impact of early parenting stress on preschool-aged children’s mental health remains unclear. The objective was to evaluate the association between parenting stress during infancy and mental health problems in 3-year-old children. Methods A prosp...
Article
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Background Attention deficit hyperactivity disorder (ADHD) affects approximately 3% of adults globally. Many pharmacologic treatments options exist, yet the comparative benefits and harms of individual treatments are largely unknown. We performed a systematic review and network meta-analysis to assess the relative effects of individual pharmacologi...
Article
Background Emotional problems such as anxiety and low mood have been associated with sleep problems in children. Objectives This study’s objective was to assess the association between sleep duration and internalizing symptoms in children age 5-12 years (y). Next, we evaluated whether meeting the National Sleep Foundation’s guidelines for sufficie...
Article
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Objective: Primary care practitioners determine access to care for many preschool children with mental health (MH) problems. This study examined rates of mental health (MH) problem identification in preschoolers within primary healthcare settings, related service use, and MH status at follow-up. The findings may inform evidence-based policy and pr...
Article
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Importance Parents may use screen exposure or screen exposure combined with feeding for infants and toddlers to alleviate their own stress. Objective To evaluate the association of individual and contextual stressors with child screen exposure (CSE) and CSE combined with feeding (CSE+F) in children aged 7 to 18 months as measured by parent-reporte...
Chapter
This collection offers an evidence-based approach to evaluating children for ADHD. https://shop.aap.org/pediatric-collections-adhd-evaluation-and-care-paperback/
Article
Psychostimulants are one of the safest and most efficacious pharmacological interventions for a psychiatric disorder. In 1999, the groundbreaking Multimodal Treatment of Attention-Defici/Hyperactivity Disorder (MTA) Study set the standard of care for long-term treatment for children with attention-deficit/hyperactivity disorder (ADHD).1 Since then,...
Article
Attention-deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder. Three position statements have been developed by the Canadian Paediatric Society, following systematic literature reviews. Statement objectives are to: • 1) Summarize the current clinical evidence regarding ADHD, • 2) Establish a standard for ADHD care, and •...
Article
Le trouble de déficit de l’attention/hyperactivité (TDAH) est un trouble neurodéveloppemental chronique. La Société canadienne de pédiatrie a préparé trois documents de principes après avoir effectué des analyses bibliographiques systématiques. Leurs objectifs s’établissent comme suit : • 1) Résumer les données probantes cliniques à jour sur le TD...
Article
What happens when hyperactive little boys grow up? Drs. Klein, Mannuzza, and their research team have been examining this important question for more than three decades. Ramos-Olazagasti et al., published in this issue of JAACAP, provide details regarding early predictors of adult functioning for children with attention-deficit/hyperactivity disord...
Article
Introduction The quality of clinical practice guidelines (PGs) has not been evaluated in child and youth mental health (CYMH). To address this gap, we will: (1) conduct a systematic review (SR) to answer the question ‘among eligible PGs relevant to the prevention or treatment of CYMH conditions, which PGs meet criteria for minimum and high quality?...
Article
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Background Adolescence and young adulthood is a vulnerable time during which young people experience many development milestones, as well as an increased incidence of mental illness. During this time, youth also transition between Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). This transition puts many y...
Article
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Chez les enfants d’âge préscolaire, les comportements perturbateurs sont d’importants facteurs de risque et des éléments potentiels de troubles du neurodéveloppement et de la santé mentale. Entre l’âge de deux et cinq ans, il est normal d’observer des comportements transitoires comme un certain défaut de se conformer, des crises de colère et de l’a...
Article
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Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some noncompliance, temper tantrums and aggression between 2 and 5 years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when accompanie...
Article
Full-text available
Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some non-compliance, temper tantrums and aggression between two and five years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when acco...
Article
Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some non-compliance, temper tantrums and aggression between two and five years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when acco...
Article
With increasing awareness that ADHD is chronically disabling, a burgeoning literature has examined childhood clinical indicators of ADHD persistence. This study investigates whether childhood factors reflecting biological risk and cognitive reserve have additive predictive value for the persistence of ADHD that is unique beyond childhood indicators...
Article
Mental health in children with neuromotor disorders is part of a dynamic system, including medical and developmental domains, family, school and community. Presentations are often complex and multifactorial, requiring a broad, individualized approach. A narrative overview of mental health symptoms in children with neuromotor disabilities is provide...
Article
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Suicide is a leading cause of death among Canadian adolescents. The present practice point provides paediatricians and child health professionals with a framework for assessing the adolescent with suicidal thoughts and/or behaviours. The epidemiological context, general considerations and practical suggestions for how to approach the suicidal adole...
Article
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Objective: To compare rates of early addictive behaviours in a clinic sample of youth with childhood attention-deficit/hyperactivity disorder (ADHD) with those in community populations. Method: We surveyed 142 adolescents (14.1 ± 1.14 years), diagnosed with ADHD before age 12, about early substance use and problem gambling using questions from t...
Article
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Young adolescents' and their parents' experiences with Attention-Deficit/Hyperactivity Disorder (ADHD) and its treatment were explored to investigate beliefs and attitudes regarding use of stimulant medication, and their influence on treatment decisions. Using in-depth qualitative interviews, 12 adolescents with ADHD aged 12 - 15 years, and their p...
Data
Homogeneity of variance of the cognitive measures. Table S1. Correlations between diagnostic criteria.
Article
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Response inhibition, working memory, and response variability are possible endophenotypes of ADHD based on their association with the disorder and evidence of heritability. One of the critical although rarely studied criteria for a valid endophenotype is that it persists despite waxing and waning of the overt manifestations of the disorder, a crite...
Article
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Safe and effective medication for attention deficit hyperactivity disorder (ADHD) is available and recommended as first-line treatment for the core symptoms of inattention, overactivity and impulsiveness. Despite impaired functioning during adolescence, many discontinue medication treatment. For children, healthcare decisions are usually made by th...
Article
Objectives: The US Agency for Healthcare Research and Quality sponsored a comparative effectiveness review of interventions for preschoolers at risk for attention-deficit/hyperactivity disorder (ADHD). Methods: Medline, Cochrane CENTRAL, Embase, PsycInfo, and Education Resources Information Center were searched from 1980 to November 24, 2011. Se...
Article
Attention-deficit hyperactivity disorder (ADHD) is a complex polygenic disorder. This study aimed to discover common and rare DNA variants associated with ADHD in a large homogeneous Han Chinese ADHD case-control sample. The sample comprised 1,040 cases and 963 controls. All cases met DSM-IV ADHD diagnostic criteria. We used the Affymetrix6.0 array...
Article
Introduction Nonadherence is the Achilles heel of effective psychiatric treatment. The meaning of the term “adherence” has evolved over time and is now associated with a variety of definitions and measurement methods. This has resulted in a poorly operationalized and non-standardized term that is often interpreted differently by providers and patie...
Article
The likelihood that patients with attention-deficit hyperactivity disorder (ADHD) will start stimulant medication can generally be identified at the initial diagnostic assessment. There are 4 empirically supported theoretical models of behavior that can be applied to medication adherence in children and adolescents who take stimulants for ADHD. The...
Book
Objectives:(1) Compare effectiveness and adverse events of interventions (pharmacological, psychosocial, or behavioral, and the combination of pharmacological and psychosocial or behavioral interventions) for preschoolers at high risk for attention deficit hyperactivity disorder (ADHD); (2) compare long-term effectiveness and adverse events of inte...
Article
Attention-deficit/hyperactivity disorder (ADHD) is a common childhood psychiatric disorder characterized by abnormal levels of hyperactivity and distractibility. However, very few studies have been conducted to examine how youth with ADHD view themselves in the context of their disorder. The aim of this project was to examine what youth think about...
Article
Full-text available
Nonadherence is the Achilles' heel of effective psychiatric treatment. It affects the resolution of mental health symptoms and interferes with the assessment of treatment response. The meaning of the term adherence has evolved over time and is now associated with a variety of definitions and measurement methods. The result has been a poorly operati...
Article
In recent years cohort studies have examined childhood attention-deficit/hyperactivity disorder (ADHD) as a risk factor for substance use disorders (SUDs) in adolescence and young adulthood. The long-term risk is estimated for development of alcohol, cannabis, combined alcohol and psychoactive SUDs, combined SUDs (nonalcohol), and nicotine use diso...
Article
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The experiences of parents of a child who received an initial diagnosis of attention-deficit hyperactivity disorder (ADHD) were examined to determine the ways in which they may have encountered stigmatizing situations. Forty-eight parents of children aged six to 18 years were interviewed about their experiences leading up to their child's ADHD diag...
Article
High scores on the National Longitudinal Survey of Children and Youth Hyperactivity/Inattention Subscale (NLSCY H/I Scale) have been used to indicate severe inattention and overactivity representing Attention Deficit/Hyperactivity Disorder (ADHD) symptoms. However, a threshold on the scale has not been identified for use as an epidemiological marke...
Article
Predictive validity of the Conners' Teacher Rating Scale-Revised (CTRS-R) was evaluated against a semi-structured clinical teacher interview in school children referred for diagnostic assessment of attention-deficit hyperactivity disorder (ADHD). We hypothesized that extreme scale values would increase diagnostic certainty and that classification e...
Article
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The objective of this study was to examine the predictors associated with adherence to atypical antipsychotic medication following discharge from hospital for children and adolescents with first-episode psychosis. Sixty-five children and adolescents, age 15.35 +/- 2.08 years, 59% boys, who had participated in a longitudinal cohort study examining r...
Article
Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder of childhood, characterized by excessive inattention, hyperactivity and impulsivity. Effective medication exists for the condition, yet suboptimal long-term effects persist for children with ADHD. Poor adherence is a common issue for individuals with chronic conditions...
Article
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This study evaluates the validity, inter-rater reliability, and stability over 3 months of a semi-structured telephone interview measuring adherence to stimulant treatment, the Stimulant Adherence Measure, against the Medication Event Monitoring System (MEMS). Clinic-referred children (N=22, age 11.85 +/- 2.1 yrs) using psychostimulants for DSM-IV...
Article
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This article provides a theoretical review of treatment adherence for children and youth with psychiatric disorders where pharmacological agents are first-line interventions. Four empirically based models of health behavior are reviewed and applied to the sparse literature about medication adherence for children with attention-deficit/hyperactivity...
Article
The goal of this study was to compare the predictive validity of the two main diagnostic schemata for childhood hyperactivity - attention-deficit hyperactivity disorder (ADHD; Diagnostic and Statistical Manual- IV) and hyperkinetic disorder (HKD; International Classification of Diseases- 10th Edition). Diagnostic criteria for ADHD and HKD were used...
Article
We compared the predictive validity of attention deficit hyperactivity disorder (ADHD; Diagnostic and Statistical Manual - IV Edition) and hyperkinetic disorder (HKD; International Classification of Diseases - 10th Edition) while controlling for the presence of comorbid psychopathology. ADHD and HKD criteria were used to classify 804 clinic-referre...
Article
Long-term adherence to stimulant treatment for Attention Deficit Hyperactivity Disorder (ADHD) is frequently poor. Since parents are the key decision makers regarding their child's health care, their thoughts regarding medication use are crucial to whether children take prescribed stimulants. To develop an understanding of what parents think about...
Article
Long-term effects of psychostimulants on growth in height and in weight are investigated in children with attention-deficit/hyperactivity disorder. Participants were 79 children, 6 to 12 years of age, with attention-deficit/hyperactivity disorder, who were followed annually for up to 5 years, between the years 1993 and 1994 and 1998 and 1999. Annua...
Article
This study aimed to estimate the prevalence of methylphenidate (MPH) use among Canadian children aged 2 to 11 years, from 1994-1995 to 1998-1999 and to identify sociodemographic, child, and parent-family correlates are identified. Cross-sectional data collections from the National Longitudinal Survey of Children and Youth (NLSCY) for 1994-1995, 199...
Article
To evaluate the impact of adherence and medication status on effectiveness and adverse effects of stimulant use in children with attention-deficit/hyperactivity disorder (ADHD) over 5 years. Seventy-nine of 91 participants in a 12-month randomized controlled trial of methylphenidate and parent groups enrolled in a follow-up study. Adherence to stim...
Article
To identify moderators and mediators of long-term adherence to stimulant medication in children with attention-deficit hyperactivity disorder (ADHD). Seventy-one children with ADHD were prescribed methylphenidate, followed prospectively on an annual basis for 3 years, and evaluated for adherence to stimulant treatment. The study occurred in Toronto...

Citations

... These levels of prevalence can be explained by the COVID-19 context. Indeed, it has been shown that the use of screen technologies has approximately doubled among children and teenagers since before the onset of the pandemic (Li et al., 2021;Ophir et al., 2022) and adolescents were confined to their homes for at least one lockdown period (Gewirtz-Meydan et al., 2021), triggering feelings of isolation. According to recent studies, the highest increase in screen use has been for the purposes of entertainment among young children and adolescents (Götz et al., 2020;Ophir et al., 2022;Schmidt et al., 2020). ...
... Many of us attended online school or worked from home and were restricted from attending recreational and sports programs (with gyms temporarily closed), and more of us were sedentary and using screens because of pandemic-related restrictions. 17 Evidence has shown that Canadian children and their caregivers largely adhered to public health measures, such as staying home and limiting social gatherings; however, adherence to public health measures was associated with reduced physical activity and increased screen time among children and youth, 18 and increased screen time has been associated with depression, anxiety, hyperactivity and irritability among young people. 19 Overall, Canadians have been less active, and when they were active also changed. ...
... Although adolescents are less susceptible than adults to developing severe cases of COVID-19 [14], many experts claim that the impact of the pandemic on adolescents' mental health will be profound and emphasize the need to conduct more research [4,15]. Several factors have been recognized to influence adolescents' mental health during Research has shown that the disruption of social life caused by confinement, quarantine, and social restrictions is associated with loneliness, post-traumatic stress symptoms, confusion, depression, anxiety, irritability, and anger [16][17][18]. ...