1. Cerda N, Shahidullah JD, Kates C, Marquez A, Diekroger EA, Fogler J. Challenging Case: Health Care Professionals as Cultural Brokers for a Boy From Central America With Attention-Deficit Hyperactivity Disorder and Trauma and Stressor-related Disorder. J Dev Behav Pediatr. 2026.

« Javier » is an 8-year-old boy with a complex psychosocial history presenting for a developmental-behavioral pediatrics consultation because of concerns regarding hyperactivity (affecting safety) and developmental delays, including « lack of independence. » He is not yet toilet trained and in his mother’s words, « he has the mindset of a child that is much younger than his actual age. » Javier’s family emigrated to the United States from Central America a year ago to seek asylum. During his family’s journey to the United States, Javier and his mother were kidnapped and sexually assaulted. On settling into the United States, Javier was evaluated by his local school district and qualified for specialized services. His mother is not aware of what support he receives at school and is concerned that he is not making sufficient progress. He has not previously received developmental therapies or psychosocial interventions.Javier has demonstrated developmental delays, including reduced reciprocal social communication skills, since birth. His mother shared that he was not able to attend school in Central America as « no schools had the resources to educate him. » He began speaking around age 5 years and currently communicates using phrased speech. There have been long-standing safety concerns related to his impulsivity, including wandering, which first emerged in his early toddler years. His hyperactivity predates his history of trauma and sexual abuse. Currently, he demonstrates intermittent physical aggression toward family members. He is interested in fire and has set objects on fire in the home. He is also drawn to placing items in electrical outlets, which has resulted in multiple self-electrocutions.Javier does not have medical insurance but receives limited health coverage through a program for uninsured residents with low income. He was evaluated by a psychiatrist and prescribed 2 medications, although his mother does not know the names of the medications prescribed. Review of psychiatry records indicated that he was prescribed guanfacine extended-release and amphetamine and dextroamphetamine salts extended release. These medications led to improvements in his behavior regulation, although he was not able to take these medications consistently because of cost.Javier’s developmental evaluation included assessment of his cognitive, adaptive, and social communication skills in his native language. His diagnostic evaluation yielded provisional diagnoses of autism spectrum disorder with accompanying speech and intellectual impairment. Psychiatric diagnostic impressions included complex attention-deficit/hyperactivity disorder in the context of his significant trauma history. His mother did not have prior conceptualization of developmental or psychiatric diagnoses, and psychoeducation through a cultural lens was provided. What are your next steps in partnering with Javier’s family as they navigate medical and educational systems following their recent arrival to the United States?* « Javier is a pseudonym ».

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2. Chiu J, Nikirk J, Brown A, Woolford M. Symptomatic improvement in fibromyalgia after treatment of comorbid attention deficit hyperactivity disorder: a case report. J Med Case Rep. 2026.

BACKGROUND: Attention deficit hyperactivity disorder is a common disorder that has an association with fibromyalgia. The connection between the two is incompletely understood but may be due to specific neurotransmitter abnormalities. Atomoxetine, a selective norepinephrine reuptake inhibitor mainly used for attention deficit hyperactivity disorder, has shown promise in relieving symptoms of attention deficit and chronic pain. However, its effectiveness in treating both conditions simultaneously has not been thoroughly studied. CASE PRESENTATION: We present the case of a 33-year-old white female patient with attention deficit hyperactivity disorder and generalized pain and fatigue from suspected fibromyalgia syndrome. Investigative labs were unremarkable. Atomoxetine was prescribed as the primary treatment intervention to target attentive symptoms. Interestingly, the patient’s symptoms related to both attention deficit hyperactivity disorder and suspected fibromyalgia significantly improved within the first 2 weeks, with continuous relief over the next 9 months. The patient also reported improved quality of mood, sleep, and tolerance of physical activity. CONCLUSION: This case of a 33-year-old female with attention deficit hyperactivity disorder and chronic pain suspicious for fibromyalgia showed the improvement of pain symptoms with atomoxetine. While a few published cases have demonstrated a similar finding, this case is notable for the dramatic improvement and the response to a nonstimulant medication-atomoxetine. This case highlights the need for further research into the connection between attention deficit hyperactivity disorder and chronic pain, as well as the mechanism behind the effects of atomoxetine on pain.

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3. Einziger T, Frenkel TI. Unpacking temperamental risk: Interactions among infant temperamental domains of reactivity and regulation differentially predict attention-deficit/hyperactivity and anxiety/depression symptoms. Infant Behav Dev. 2026; 83: 102190.

Early dispositions in temperamental domains of motor reactivity, negative emotionality (NE), and regulatory capacities are transdiagnostic risk factors for psychopathology, including symptoms of attention-deficit/hyperactivity disorder (ADHD) and anxiety/depression. However, prior research examining broad temperament constructs may obscure disorder-specific patterns. Fine-grained distinctions within domains (e.g., anger vs. fear within NE) and their interactions have rarely been investigated for disorder-specific outcomes. The present study examined whether interactive effects among motor reactivity, NE (anger vs. fear), and regulatory capacities assessed at 4 months uniquely predicted ADHD and anxiety/depression symptoms at 5 years. The study contributes to existing literature in two ways: first, unlike research focused on later-emerging effortful control, early precursory regulatory capacities were assessed at 4 months to predict later psychopathology risk. Second, while accounting for overlap between outcomes and disaggregating NE into fear and anger, both transdiagnostic and disorder-specific risk pathways were examined. Ninety-one infants participated (54.94% male; all White; 71.76% with monthly household income >$3400). Parent-reported and observational measures of temperament were collected at 4 months, and mothers reported child symptoms at age 5 years. Lower regulatory capacities, both independently and combined with high anger or motor reactivity, specifically predicted ADHD symptoms. Lower regulatory capacities conferred risk for higher-reactive infants, whereas higher regulatory capacities conferred protective effects for higher-reactive infants. Conversely, high fear combined with high motor reactivity specifically predicted anxiety/depression symptoms. Early identification of fine-grained disorder-specific temperamental risk may inform targeted preventive interventions tailored to children’s temperamental profiles.

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4. Irmak DE, Bumin G. The Turkish adaptation of the Child Occupational Self-Assessment Scale (COSA) and its psychometric properties in children with attention-deficit/hyperactivity disorder. BMC Psychol. 2026.

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5. Lee DH, Suarez-Lopez JR. Maternal Diabetes Mellitus and Child Neurodevelopmental Disorders: Rethinking Causality in Light of Environmental Pollutants. J Korean Med Sci. 2026; 41(10): e110.

Numerous epidemiological studies have linked maternal diabetes mellitus (DM) to neurodevelopmental disorders in offspring, such as autism spectrum disorder and attention-deficit/hyperactivity disorder. However, recent evidence challenges a direct causal relationship: sibling-matched analyses show similar risks regardless of gestational DM status, and glycemic control during pregnancy does not consistently predict neurodevelopmental outcomes. We propose that exposure to environmental pollutants-rather than DM itself-may underlie these associations. Although usually examined separately, many pollutants both increase DM risk and disrupt fetal brain development, providing a biologically plausible basis for the observed epidemiological patterns. Because fetuses encounter these pollutants via placental transfer from maternal blood, understanding what determines maternal circulating pollutant levels is essential. Two major sources contribute: (1) ongoing external exposure through food, air, water, and consumer products, and (2) the release of previously accumulated lipophilic pollutants stored in adipose tissue. Often overlooked, adipose tissue serves as an important reservoir, and lipolysis mobilizes these compounds into circulation. Importantly, key pathophysiological features of DM-insulin resistance and insulin deficiency-accelerate lipolysis, increasing circulating pollutant levels. These pollutant-related mechanisms may also account for associations observed with other maternal conditions, such as obesity, eating disorders, psychological stress, and intrahepatic cholestasis of pregnancy, all of which may also be linked to elevated pollutant levels in maternal circulation. These insights suggest that maternal risk factors should be reconsidered in light of toxicokinetic dynamics, particularly the mobilization of lipophilic pollutants stored in fat. This perspective may offer a unifying explanation for otherwise disparate epidemiological findings and help guide more effective prevention strategies.

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6. Pliszka SR. Letter: Polypharmacy and Diabetes in Attention-Deficit/Hyperactivity Disorder: A Comment on Zhu et al. J Child Adolesc Psychopharmacol. 2026: 10445463261434898.

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7. Thomson P, Rakesh D. Editorial: ADHD persistence – the interplay of genes, socioeconomic context, and symptom domains over development. J Child Psychol Psychiatry. 2026.

Persistence of childhood ADHD symptoms into adolescence and adulthood is common. However, persistence is not simply a continuation of early high severity ADHD. Rather, it is the product of influences from individual-level genetic liability, one’s environmental context, and their interplay. The field has often focused on cross-sectional ADHD severity and genetic load. However, environments – such as one’s socioeconomic context – exert their own influence over development independently of genetics, as well as modulate genetic influences. Importantly, these genetic and environmental effects vary significantly between inattention and hyperactivity/impulsivity symptom domains, emphasizing the need to consider these domains separately when studying persistence risk. This article outlines a unifying persistence framework reflecting the changing contributions of genes, environmental context, and their interaction over time, offering a path to a more complete understanding of risk for symptom persistence.

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