Early Morning Functioning in Stimulant-Treated Children and Adolescents with Attention-Deficit/Hyperactivity Disorder, and its Impact on Caregivers

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Abstract
Objective: The purpose of this study was to examine the temporal occurrence and severity of inadequate attention-deficit/hyperactivity disorder (ADHD) symptom control throughout the day, and, more specifically, the frequency and severity of associated functional impairments and their apparent emotional impact on parents and caregivers during the early morning routine before school, in children and adolescents with ADHD currently treated with stable doses of stimulant medications. Methods: Information was obtained from 201 primary caregivers of children and adolescents with ADHD using a self-administered, on-line quantitative research survey. Results: Inadequately controlled ADHD symptoms were rated as most severe during the evening homework time and the early morning routine. The majority of caregivers reported early morning ADHD symptoms and impairment of early morning functioning (EMF) as moderate to severe. Caregiver reactions to their child's early morning ADHD symptoms and unwanted behaviors included feeling overwhelmed, exhausted, and constantly stressed. Conclusions: Control of EMF impairments from inadequately controlled ADHD symptoms is a significant unmet need in children and adolescents with ADHD treated with stable morning doses of stimulant medications. Current orally administered stimulant treatment options have not addressed this challenge.

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