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Open research questions in Attention Deficit Hyperactivity Disorder

448 unresolved questions extracted from the limitations and future-work sections of 5,042 Attention Deficit Hyperactivity Disorder papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Although the PK profile of CTx-1301 suggests differences in the temporal distribu- tion of exposure compared with d-MPH XR, the clinical relevance of these differences remains uncertain. Future multiple-dose and clinical efficacy and safety studies are warranted to determine whether these PK characteristics translate into clinical benefits for patients with ADHD.

    Comparative Bioavailability of Trimodal (CTx-1301) Versus Bimodal Dexmethylphenidate Modified-Release Formulations in Adults with Attention-Deficit/Hyperactivity Disorder: A Randomized, Single-Dose, Crossover Study · 2026 · DOI

  • Investigating the relationship between IQ and the core symptoms of ADHD is a compelling research area that has not been thoroughly explored before. However, this relationship has not been thoroughly examined in ADHD populations with stringent clinical diagnosis and thorough cognitive evaluations. The dual impact of VIQ warrants closer examination.

    The paradox of high IQ in ADHD: dissociable effects on inattention and impulsivity – insights from behavior, cognition & brain in 5138 children · 2026 · DOI

  • Electrooculography (EOG) has been suggested as a low-burden marker of neurophysiological processes relevant to ADHD, but its responsiveness to medication within routine clinical settings is not well established.

    Short-Latency Changes in Closed-Eye EOG Following Medication Intake in ADHD · 2026 · DOI

  • Abstract Background Behavioral parent training (BPT) is an evidence‐based intervention for children with attention‐deficit/hyperactivity disorder (ADHD); however, evidence from low‐ and middle‐income Asian countries remains scarce.

    Effectiveness of a blended online behavioral parent training program for Vietnamese parents of children with ADHD: A randomized controlled trial with 3‐month follow‐up · 2026 · DOI

  • Although ENC and ADHD frequently co-occur and show some overlapping clinical correlates, they also appear to have partially distinct clinical profiles Our findings suggest that managing ENC solely as an isolated gastrointestinal problem may limit effective clinical management, particu- larly in the presence of comorbid ADHD. To effectively manage children with ENC and comorbid ADHD, it is cru- cial to support executive functioning, appropriately address comorbid psychiatric symptoms, and target eating-related fears as fundamental components of a holistic intervention. Furthermore, our findings suggest that ENC may be asso- ciated with a distinct profile of internalizing vulnerability, Research on Child and Adolescent Psychopathology (2026) 54:641 3 64 Page 16 of 18 emphasizing the importance of comprehensive evaluation of these children with regard to internalizing symptoms, adverse childhood events, and eating-related fears. Future longitudinal and intervention-focused studies would be important in revealing the long-term clinical outcomes of this holistic approach, as well as identifying which sub- groups benefit most from which interventions. Supplementary Information The online version contains supplementary material available at h t t p s : / / d o i . o r g / 1 0 . 1 0 0 7 / s 1 0 8 0 2 - 0 2 6 - 0 1 4 6 3 - w. Author Contributions All authors contributed to the conceptualiza- tion and methodology of the study. M.E.Ö. led the formal analysis and supervised the research process. Data collection was conducted by M.E.Ö. and H.G.O., with additional contributions from N.Ö. and H.S. H.G.O., N.Ö., and H.S. prepared the preliminary draft of the manu- script. All authors reviewed and edited the manuscript, provided criti- cal feedback on earlier versions, and approved the final version. Funding Open access funding provided by the Scientific and Tech- nological Research Council of Türkiye (TÜBİTAK). This research received no specific grant from any funding agency in the public, com- mercial, or not-for-profit sectors. Data Availability The datasets analyzed in the current study are avail- able from the corresponding author upon reasonable request.

    Independent and Interactive Associations of Encopresis and Attention-Deficit/Hyperactivity Disorder in Children on Emotional–Behavioral Symptoms, Executive Functioning, and Avoidant/Restrictive Food Intake–Related Symptoms · 2026 · DOI

  • Further- more, as the study was conducted in a clinical sample, the findings may not be generalizable to the general population. Rather than implying that eating-related symp- toms constitute a core feature of ENC-ADHD comorbidity, our results suggest that they may reflect one clinically rel- evant and relatively understudied domain within a broader multidimensional self-regulatory profile.

    Independent and Interactive Associations of Encopresis and Attention-Deficit/Hyperactivity Disorder in Children on Emotional–Behavioral Symptoms, Executive Functioning, and Avoidant/Restrictive Food Intake–Related Symptoms · 2026 · DOI

  • The peer groups were also comprised entirely of children diag- nosed with ADHD, which may not be generalizable to situ- ations with less concentration of individuals with ADHD playing the game together.

    Examination of Peer Interactions During Cooperative and Competitive Board Games Among Children with Attention-Deficit/Hyperactivity Disorder on and off Methylphenidate · 2026 · DOI

  • Finally, this study demonstrates that board games may be a reasonable setting for evaluating the effects of medication on the social behavior of children with ADHD. Approaches to evaluate effects of medication emphasize classroom behav- iors and academic productivity, often through teacher rat- ings on checklists. To evaluate ADHD impairment in social settings, more intensive measurement approaches should be used (e.g., sociometric ratings; Erhardt & Hinshaw, 1994; Mikami et al., 2022), or field/gymnasium space for assess- ment in intensive treatment settings (Pelham et al., 1990, 2014). These approaches may not be feasible in many clini- cal settings. The board game settings may provide a reason- able middle ground to meaningfully assess social impairment in children, and provide socially valid assessment of medi- cation, or through future studies, psychosocial treatment response. Future studies might explore board games as a venue for direct psychosocial intervention efforts, as well as continued assessment of peer interactions for children with ADHD. Early explorations of peer relationships in children with ADHD utilized similar small group activities (Pelham et al., 2001). Direct observation of peer interactions, as was used in the present study, may be especially critical as adults may miss nuances that enhance or impair peer interactions (Craig & Pepler, 1998). Given the reduction in challenging behaviors observed when using medication, and for the teas- ing behavior outcome during cooperative games, this repre- sents a potential vehicle for promoting peer relationship skill application in children with ADHD. Supplementary Information The online version contains supplementary material available at h t t p s : / / d o i . o r g / 1 0 . 1 0 0 7 / s 1 0 8 0 2 - 0 2 6 - 0 1 4 4 2 - 1. Author Contributions MJ: Conceptualization; Formal analysis; Meth- odology; Visualization; Writing – original draft; Writing – review and editing. BM: Conceptualization; Data curation; Methodology; Super- vision; Writing – review and editing. ES: Investigation; Data cura- tion; Writing – original draft. JS: Data curation; Writing – review and editing. GE: Investigation; Writing – review and editing. TH: Formal Research on Child and Adolescent Psychopathology (2026) 54:571 3 57 Page 12 of 15 analysis; Methodology; Visualization; Writing – review and editing. DT: Project administration; Data curation. AB: Project administration; Data curation. GF: Conceptualization; Methodology; Funding acquisi- tion; Resources; Supervision; Writing – original draft. Funding This work was funded by the Eunice Kennedy Shriver Na- tional Institute of Child Health and Human Development awarded to Florida International University (R01HD105318). Morgan L. Jusko was supported by the National Institute on Alcohol Abuse and Alco- holism (NIAAA T32 AA007453) during manuscript preparation. Data Availability Data and materials are available from the corre- sponding author upon reasonable request.

    Examination of Peer Interactions During Cooperative and Competitive Board Games Among Children with Attention-Deficit/Hyperactivity Disorder on and off Methylphenidate · 2026 · DOI

  • Future research should examine whether the prom- inent outcome of negative self-evaluation is upheld with older adolescents. Future research should examine the extent to which social skills functioning plays a more prominent role in the development of depression in older adolescents than children with ADHD. Given this limitation, it is possible that our results will not apply to all races, and it remains unclear how race could impact our results. Another limitation of the present study is that the RADS-2 scores were in the non-clinical range (T-scores were less than 60).

    Linking ADHD to Depression in Adolescents: the Mediating Role of Social Skills · 2026 · DOI

  • The results warrant further exploration into the role of perceived fairness, as well as other aspects of school climate, in the academic functioning of adolescents with ADHD.

    Perceived School Fairness and Academic Functioning in Early Adolescents: Differential Associations for Adolescents with or Without ADHD? · 2026 · DOI

  • Given that the mechanisms under- lying child hyperactivity–inattention problems are multifaceted including but not limited to genetic and neurobiological factors which are beyond the scope of this study, future research should examine whether disparities in the direct and indirect pathways linking food insecurity, caregiver psychological distress, and child hyperactivity–inattention vary according to these factors.

    Black-White Disparity in Child Hyperactivity-Inattention Problems in Families Living Without Sufficient Foods · 2026 · DOI

  • Yet most evidence has been from cross-sectional studies; multiyear prospective, within-person studies on an association of PSMU with ADHD symptoms are lacking.

    Problematic Social Media Use and Attention-Deficit/Hyperactivity Disorder Symptoms in Adolescents · 2026 · DOI

  • The findings from this meta-analysis demonstrate a mod- erate relation between emotion dysregulation and symp- toms of externalizing disorders. Emotional lability had a stronger relation to symptoms than emotion regulation both for ADHD and ODD/CD. The relation was stronger for overall emotion dysregulation and emotion regula- tion in children and adolescents with ADHD compared to ODD/CDD, but for emotional lability the effect sizes were equally strong. No significant moderators were found, indicating that the relation is not affected by demo- graphic variables, informant, continent, ADHD subtype or medication status. Future studies should aim to provide information regarding ADHD subtype as this information was often lacking. The results indicate that emotion dys- regulation, particularly emotional lability, is a significant factor in all three externalizing disorders and should be considered as part of assessment at the time of diagnosis. As studies have shown that emotion dysregulation con- tributes to impairment beyond the disorders’ symptoms, studies should also assess whether emotion dysregulation should be given increased attention in the development of treatment for children and adolescents with externalizing disorders. Supplementary Information The online version contains supplementary material available at h t t p s : / / d o i . o r g / 1 0 . 1 0 0 7 / s 0 0 7 8 7 - 0 2 6 - 0 3 0 9 0 - 8 . Acknowledgements The authors wish to thank Regina Küfner Lein and Ida Sofie Karlsen Sletten, academic librarians at the Medical library, University of Bergen, Norway for assistance with the literature search. Author contributions UN designed the study, wrote the protocol, screened the studies, read the full-text articles, extracted data from the included studies, wrote the first draft of introduction and discussion, and reviewed and edited the manuscript. GJW conducted the litera- ture searches in collaboration with an academic librarian, screened the studies, read the full-text articles, extracted data from the included studies, rated the studies for risk of bias, and reviewed and edited the manuscript. AMS screened the studies, read the full-text articles, ex- tracted data from the included studies, rated the studies for risk of bias and reviewed and edited the manuscript. KWF, JML, CMP, and ENR screened the studies, read the full-text articles, extracted data from the included studies, and reviewed and edited the manuscript. LGÖ de- signed the study, wrote the coding schemes, rated the studies, meta-an- alyzed the included studies, wrote the first draft of methods and results, and reviewed and edited the manuscript. Funding Open access funding provided by University of Iceland. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Data availability No datasets were generated or analysed during the current study. 1 3European Child & Adolescent Psychiatry Declarations Competing interests The authors declare no competing interests. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y / 4 . 0 / .

    Emotion dysregulation in children and adolescents with externalizing disorders: a systematic review and meta-analysis · 2026 · DOI

  • First, the quality of a meta-analysis is always restricted by the quality of the original studies and is there- fore limited by the data it summarizes. Third, data on comorbidity, as well as ADHD subtypes and medication use was lacking in many of the included studies which limits the generalizability of findings regarding these variables.

    Emotion dysregulation in children and adolescents with externalizing disorders: a systematic review and meta-analysis · 2026 · DOI

  • Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed mental health disorder, yet little is known about the priorities for funding, services, and research held by educators and ADHD coaches, particularly in Canada.

    Strategic Investment in ADHD Support: Insights from Canadian Educational and Coaching Professionals · 2026 · DOI

  • Although ADHD has been linked to perinatal complications, it remains unclear whether risks reflect ADHD itself, comorbidity, vulnerability, behaviours, and medication use.

    Exploring the association between maternal attention-deficit/hyperactivity disorder and obstetric complications: a danish population-based register study · 2026 · DOI

  • This meta-analysis addresses the substantial gap in the research concerning behavioral interventions for preschool children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) and demonstrates the effectiveness of implementing school-based behavioral interventions by analyzing existing research currently available. Thus, analysis of each intervention and its effect size is warranted.

    Effects of School-Based Interventions for Preschoolers with Attention Deficit Hyperactivity Disorder Related Behaviors: A Meta-analysis · 2026 · DOI

  • This could potentially alter the effects of the interventions as the validity of the ADHD cat- egorizations and diagnoses could not be evaluated, and some children may not have met formal diagnostic criteria.

    Effects of School-Based Interventions for Preschoolers with Attention Deficit Hyperactivity Disorder Related Behaviors: A Meta-analysis · 2026 · DOI

  • This retrospective EHR study cannot establish causality, and medication orders may not perfectly reflect dose or adherence. Fracture outcomes were identified by diagnosis codes, so some minor injuries could be missed, although limit the use of codes helps specific acute misclassification. Residual confounding may remain despite propensity matching, including ADHD severity, participation in sports or risky activities, vitamin D status, and concurrent medications that influence bone health. A plausible behavioral confounder is clonidine’s calming effect, which could reduce falls and trauma exposure independent of any direct skeletal effect; future work should capture activity levels and falls to separate behavioral from biologic pathways. Time-varying treatment (switching among clonidine, stimulants, or guanfacine) was not modeled and could modestly bias estimates. Generalizability to pediatric patients with ADHD in health systems contributing to this network. These common limitations warrant cautious interpretation but do not detract from the consistent association observed across three fracture sites. is primarily CONCLUSION fewer distal Clonidine use in children and adolescents with ADHD was associated with radius, clavicle, and supracondylar humerus fractures during follow-up. The direction and magnitude of effects were consistent across risk and time-to-event analyses, supporting a clinically meaningful reduction in fracture risk. Although this observational study does not prove causality, the findings suggest clonidine may confer protective benefits through behavioral stabilization, physiologic effects on bone metabolism, or both. These results warrant prospective confirmation and mechanistic work to determine pathways and to evaluate whether dosing, duration, or co- interventions can further lower fracture incidence. Funding: No funding sources Conflict of interest: None declared Ethical approval: Not required REFERENCES of 1. Thomas R, Sanders S, Doust J, Beller E, Glasziou P.

    Long-term clonidine and fracture risk in children with attention-deficit hyperactivity disorder: multicentre electronic health record evidence · 2026 · DOI

  • We highlighted multiple different solutions in the ADHD taskforce report that could easily be extended to mental (cid:1) 2026 The Author(s). Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

    Editorial Perspective: Overdiagnosis of <scp>ADHD</scp> ? Here we go again · 2026 · DOI

  • We already know that ADHD is underrecognised, underdiagnosed and undertreated in the United King- dom and have good data on which types of mental health conditions have risen in prevalence.

    Editorial Perspective: Overdiagnosis of <scp>ADHD</scp> ? Here we go again · 2026 · DOI

  • Substantial interindividual variability in response to GXR remains incompletely understood. The selective α2A-adrenergic mechanism targeting prefrontal cortex function provides a strong neurobiological rationale, yet validated predictors of treatment response are lacking.

    Guanfacine Extended Release in the Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Narrative Review · 2026 · DOI

  • While there are multiple known individual and wider consequences for young females with delayed or undiagnosed ADHD, little is known about mental health service utilisation (HSU) impacts.

    Implications of attention‐deficit/hyperactivity disorder diagnostic timing on mental health service utilisation in young adult females: A population‐based record linkage cohort study · 2026 · DOI

  • In addition, the association between task difficulty regulation during DTx training and ADHD symptom improvement in children has not been well studied.

    Association Between Task Difficulty Regulation in Game-Based Digital Therapeutics and Attention-Deficit/Hyperactivity Disorder Symptoms in Children: Secondary Analysis of a Randomized Controlled Trial · 2026 · DOI

  • Preadolescence is a key period during which changes in ER emerge, yet it remains understudied with respect to factors that impact ER among youth with ADHD, specifically.

    Associations Between Familial Factors and Emotion Regulation Among Preadolescents with Attention-Deficit/Hyperactivity Disorder: An ABCD Study® · 2026 · DOI

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