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Background <p>An appropriately displayed smile is elemental for social communication. Children and adolescents with attention deficit hyperactivity disorder (ADHD) often have problems with the recognition of emotions. By video-assisted observation of the smile in a play situation, the course of changes in the face of children with ADHD differed from that of unaffected children. When the methylphenidate (MPH) dose is titrated in 2.5 mg&#xa0;steps, the observed smile becomes more subtle and variable and more similar to the smile of unaffected children; however, above an optimum it becomes more rigid again. The most variable smile correlates with the best access to the computational ability.</p> Objective <p>Does the optimal MPH dose ascertained by the variability of the smile lead to a long-term success of treatment?</p> Material and methods <p>Retrospective study of all children newly diagnosed with ADHD in 1 year (<i>n</i> = 49, median age 10&#xa0;years) in a practice for pediatric and adolescent medicine. Data were collected during check-ups after 6–12&#xa0;months via file inspection and after 4 years by individual contact and a telephone interview or questionnaires. The endpoints were the information on DSM IV features given by the parents on attention, hyperactivity and impulsiveness in the questionnaire of DuPaul. In addition, the currently administered dosage of MPH at the time of follow-up was also recorded.</p> Results <p>Parents reported that a&#xa0;significant improvement in attention, hyperactivity and impulsiveness occurred in the first year of treatment which remained for a median of 51 months. The majority of patients continued to take the originally ascertained MPH dose.</p> Conclusion <p>The standardized video-assisted observation of smile variability enabled the determination of an optimal regulation condition of the behavior. The determination of the MPH dose in this way for the pharmaceutical treatment of ADHD also proved to be successful for the long-term treatment. Further studies with more participants would be desirable. The examination of the recordings improves the mutual understanding and motivation of parents and children.</p>

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Das Lächeln bei Kindern und Jugendlichen mit ADHS und sein Nutzen für die Behandlung

  • 期刊论文

  • 发表日期：

    2025年1月20日

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  • Hans-Jürgen Kühle,
  • Tanja Glaser,
  • Helge Hudel,
  • Gerhard Neuhäuser

摘要

Background

An appropriately displayed smile is elemental for social communication. Children and adolescents with attention deficit hyperactivity disorder (ADHD) often have problems with the recognition of emotions. By video-assisted observation of the smile in a play situation, the course of changes in the face of children with ADHD differed from that of unaffected children. When the methylphenidate (MPH) dose is titrated in 2.5 mg steps, the observed smile becomes more subtle and variable and more similar to the smile of unaffected children; however, above an optimum it becomes more rigid again. The most variable smile correlates with the best access to the computational ability.

Objective

Does the optimal MPH dose ascertained by the variability of the smile lead to a long-term success of treatment?

Material and methods

Retrospective study of all children newly diagnosed with ADHD in 1 year (n = 49, median age 10 years) in a practice for pediatric and adolescent medicine. Data were collected during check-ups after 6–12 months via file inspection and after 4 years by individual contact and a telephone interview or questionnaires. The endpoints were the information on DSM IV features given by the parents on attention, hyperactivity and impulsiveness in the questionnaire of DuPaul. In addition, the currently administered dosage of MPH at the time of follow-up was also recorded.

Results

Parents reported that a significant improvement in attention, hyperactivity and impulsiveness occurred in the first year of treatment which remained for a median of 51 months. The majority of patients continued to take the originally ascertained MPH dose.

Conclusion

The standardized video-assisted observation of smile variability enabled the determination of an optimal regulation condition of the behavior. The determination of the MPH dose in this way for the pharmaceutical treatment of ADHD also proved to be successful for the long-term treatment. Further studies with more participants would be desirable. The examination of the recordings improves the mutual understanding and motivation of parents and children.