1
|
Lee YS, Sprong ME, Shrestha J, Smeltzer MP, Hollender H. Trajectory Analysis for Identifying Classes of Attention Deficit Hyperactivity Disorder (ADHD) in Children of the United States. Clin Pract Epidemiol Ment Health 2024; 20:e17450179298863. [PMID: 39130191 PMCID: PMC11311732 DOI: 10.2174/0117450179298863240516070510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/12/2024] [Accepted: 04/30/2024] [Indexed: 08/13/2024]
Abstract
Background Attention Deficit Hyperactivity Disorder (ADHD) is a mental health disorder that affects attention and behavior. People with ADHD frequently encounter challenges in social interactions, facing issues, like social rejection and difficulties in interpersonal relationships, due to their inattention, impulsivity, and hyperactivity. Methods A National Longitudinal Survey of Youth (NLSY) database was employed to identify patterns of ADHD symptoms. The children who were born to women in the NLSY study between 1986 and 2014 were included. A total of 1,847 children in the NLSY 1979 cohort whose hyperactivity/inattention score was calculated when they were four years old were eligible for this study. A trajectory modeling method was used to evaluate the trajectory classes. Sex, baseline antisocial score, baseline anxiety score, and baseline depression score were adjusted to build the trajectory model. We used stepwise multivariate logistic regression models to select the risk factors for the identified trajectories. Results The trajectory analysis identified six classes for ADHD, including (1) no sign class, (2) few signs since preschool being persistent class, (3) few signs in preschool but no signs later class, (4) few signs in preschool that magnified in elementary school class, (5) few signs in preschool that diminished later class, and (6) many signs since preschool being persistent class. The sensitivity analysis resulted in a similar trajectory pattern, except for the few signs since preschool that magnified later class. Children's race, breastfeeding status, headstrong score, immature dependent score, peer conflict score, educational level of the mother, baseline antisocial score, baseline anxious/depressed score, and smoking status 12 months prior to the birth of the child were found to be risk factors in the ADHD trajectory classes. Conclusion The trajectory classes findings obtained in the current study can (a) assist a researcher in evaluating an intervention (or combination of interventions) that best decreases the long-term impact of ADHD symptoms and (b) allow clinicians to better assess as to which class a child with ADHD belongs so that appropriate intervention can be employed.
Collapse
Affiliation(s)
- Yu-Sheng Lee
- School of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois at Springfield, Illinois, United States
| | - Matthew Evan Sprong
- School of Public Management and Policy, College of Public Affairs and Education, University of Illinois at Springfield, llinois, United States
| | - Junu Shrestha
- School of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois at Springfield, Illinois, United States
| | - Matthew P. Smeltzer
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Tennessee, United States
| | - Heaven Hollender
- School of Health and Human Sciences, Indiana University Indianapolis, Indiana, United States
| |
Collapse
|
2
|
Overgaard KR, Oerbeck B, Friis S, Pripp AH, Aase H, Biele G, Ingeborgrud CB, Polanczyk GV, Zeiner P. Attention-deficit/hyperactivity disorder from preschool to school age: change and stability of parent and teacher reports. Eur Child Adolesc Psychiatry 2023; 32:1947-1955. [PMID: 35737107 PMCID: PMC10533600 DOI: 10.1007/s00787-022-02019-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/01/2022] [Indexed: 11/03/2022]
Abstract
Identifying attention-deficit/hyperactivity disorder (ADHD) in pre-schoolers may improve their development if treated, but it is unclear whether ADHD symptoms from this age are stable enough to merit treatment. We aimed to investigate the stability of parent- and teacher-reported ADHD symptoms and ADHD classified above the diagnostic symptom thresholds, including for hyperactivity-impulsivity (HI), inattention and combined presentations from age 3 to 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. At child age 3 years, parents were interviewed and teachers rated ADHD symptoms. At age 8 years, parents (n = 783) and teachers (n = 335) reported ADHD symptoms by the Child Symptom Inventory-4. We found a significant reduction in the mean number of parent-reported ADHD and HI symptoms from age 3 to 8 years, but otherwise similar mean numbers. Parent-reported ADHD symptoms were moderately correlated between ages, while correlations were low for teachers. A total of 77/108 (71%) of the children classified with parent-reported HI presentation at age 3 years were no longer classified within any ADHD presentation at age 8 years, the only clear trend across time for either informant. There was a low to moderate parent-teacher-agreement in the number of reported symptoms, and very low informant agreement for the classified ADHD presentations. Overall, clinicians should exercise caution in communicating concern about HI symptoms in preschool children. Age 3 years may be too early to apply the ADHD diagnostic symptom criteria, especially if parents and teachers are required to agree.
Collapse
Affiliation(s)
- Kristin Romvig Overgaard
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.B. 4959, 0424, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Beate Oerbeck
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.B. 4959, 0424, Oslo, Norway
| | - Svein Friis
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.B. 4959, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Guido Biele
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Guilherme V Polanczyk
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Pål Zeiner
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.B. 4959, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
3
|
Almeida ML, Garon-Carrier G, Cinar E, Frizzo GB, Fitzpatrick C. Prospective associations between child screen time and parenting stress and later inattention symptoms in preschoolers during the COVID-19 pandemic. Front Psychol 2023; 14:1053146. [PMID: 37303895 PMCID: PMC10249107 DOI: 10.3389/fpsyg.2023.1053146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 04/21/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Child attention skills are critical for supporting self-regulation abilities, especially during the first years of life. On the other hand, inattention symptoms in preschoolers have been associated with poor school readiness, literacy skills and academic achievement. Previous research has linked excessive screen time with increased inattention symptoms in early childhood. However, most research has only focused on TV exposure and did not investigate this association during the COVID-19 pandemic. This atypical context has increased screen time in children worldwide, including preschoolers. We hypothesize that higher levels of child screen media and parenting stress at age 3.5 will be associated with higher child inattention symptoms at age 4.5. Method This study draws on participants followed longitudinally over the span of 2-years for an investigation of Canadian preschoolers' screen media use during the pandemic (N = 315, 2020). A follow-up with this sample was completed in 2021 (N = 264). Results Analyses using multiple linear regression, revealed a positive association between child screen time at age 3.5 and inattention symptoms at 4.5 years. Parental stress was also positively associated with child inattention symptoms. Associations were observed above individual (child age, inhibitory control, and sex) and family (parent education and family income) characteristics. Discussion These results confirmed our hypothesis and highlight that preschooler screen use and parenting stress may undermine attentional skills. Since attention is a crucial component for children development, behavior and academic outcomes, our study reinforces the importance for parents of adopting healthy media habits.
Collapse
Affiliation(s)
- Maíra Lopes Almeida
- Département de l’enseignement au préscolaire et au primaire, Faculté d`Éducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Gabrielle Garon-Carrier
- Département de psychoéducation, Faculté d`Éducation, Université de Sherbrooke, Sherbrook, QC, Canada
| | - Eda Cinar
- Département de psychoéducation, Faculté d`Éducation, Université de Sherbrooke, Sherbrook, QC, Canada
| | - Giana Bitencourt Frizzo
- Departamento de Psicologia do Desenvolvimento e Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Caroline Fitzpatrick
- Département de l’enseignement au préscolaire et au primaire, Faculté d`Éducation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Childhood Education, Faculty of Education, University of Johannesburg, Johannesburg, South Africa
| |
Collapse
|
4
|
Thériault-Couture F, Matte-Gagné C, Dallaire S, Brendgen M, Vitaro F, Tremblay RE, Séguin JR, Dionne G, Boivin M. Child Cognitive Flexibility and Maternal Control: A First Step toward Untangling Genetic and Environmental Contributions. J Genet Psychol 2023; 184:55-69. [PMID: 36102122 DOI: 10.1080/00221325.2022.2121638] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Executive functions (EF) play an essential role in many spheres of child development. Therefore, it is crucial to get a better understanding of their etiology. Using a genetic design that involved 934 twins (400 monozygotic), this study examined the etiology of cognitive flexibility, a component of EF, at 5 years of age and its phenotypic and etiological associations with maternal control. Cognitive flexibility was measured in a laboratory setting at 5 years of age using a well-known EF-task, i.e. the Dimensional Change Card Sort (DCCS). Maternal control was measured using a self-report questionnaire. The univariate genetic model demonstrated that environmental factors mainly explained individual differences in preschoolers' performance on the DCCS task. A bivariate genetic model demonstrated that non-shared environmental mechanisms mainly explained the association (r = .-13) between maternal control and children's performance on the DCCS task. This study represents a preliminary step toward a better understanding of the genetic and environmental contributions underlying the relation between parenting behaviors and children's EF.
Collapse
Affiliation(s)
| | | | - Samuel Dallaire
- School of Psychology, Université Laval, Quebec, Quebec, Canada
| | - Mara Brendgen
- Department of Psychology, University of Quebec in Montreal, Montreal, Quebec, Canada.,CHU Ste-Justine Research Center, Montreal, Quebec, Canada
| | - Frank Vitaro
- CHU Ste-Justine Research Center, Montreal, Quebec, Canada.,School of Psychoeducation, University of Montreal, Montreal, Queebec, Canada
| | - Richard E Tremblay
- Department of Pediatrics and Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Jean R Séguin
- CHU Ste-Justine Research Center, Montreal, Quebec, Canada.,Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
| | - Ginette Dionne
- School of Psychology, Université Laval, Quebec, Quebec, Canada
| | - Michel Boivin
- School of Psychology, Université Laval, Quebec, Quebec, Canada
| |
Collapse
|
5
|
Martin CP, Shoulberg EK, Hoza B. The Developmental Course of Teacher-Rated ADHD Symptom Levels in an Early Childhood Community Sample. J Atten Disord 2022; 26:456-466. [PMID: 33660546 DOI: 10.1177/1087054721997561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study examined trajectories of inattention and hyperactivity/impulsivity symptom levels across one preschool year and explored variation in trajectories by age, sex, and end-of-year impairment. METHOD Participants were 261 preschoolers (87% Head Start; 59% Caucasian; 53% boys; Mage = 3.97 years). Teachers rated ADHD symptom levels four times throughout one academic year. RESULTS Results showed a course of increasing inattention that decelerated over time and steadily increasing hyperactivity/impulsivity. Group-based finite mixture modeling revealed three trajectories of inattention: stable low (57%), change (32%), and stable high (11%), as well as three trajectories of hyperactivity/impulsivity: stable low (63%), increasing (26%), and stable high (11%). Compared to children with increasing or changing symptoms levels, children with stable high levels were more impaired and children with stable low symptom levels were less impaired. CONCLUSION Findings suggest a "wait and see" approach to treatment may miss an important opportunity for early intervention.
Collapse
|
6
|
Murray AL, Hall HA, Speyer LG, Carter L, Mirman D, Caye A, Rohde L. Developmental trajectories of ADHD symptoms in a large population-representative longitudinal study. Psychol Med 2021; 52:1-7. [PMID: 33769236 DOI: 10.1017/s0033291721000349] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Previous research has suggested that there is substantial heterogeneity in the developmental trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms. Sometimes, qualitative distinctions between trajectories with different ages of onset and/or patterns of remission are made; however, little is known about the predictors and broader clinical meaningfulness of these candidate 'developmental subtypes' of ADHD symptoms. METHODS We applied latent class growth analysis to data from the UK Millennium Cohort Study (MCS; N = 11 316; ages 3, 5, 7, 11 and 14) to evaluate whether developmental trajectories of ADHD symptoms differing in early life predictors could be identified. Our optimal model included six trajectory groups, labelled unaffected (34.9% of the sample), mildly affected (24.1%), subclinical remitting (12.8%), pre-school onset partially remitting (14.1%), developmentally increasing (7.6%) and pre-school onset persistent (6.4%). RESULTS Factors such as gender, conduct problems, cognitive ability, maternal education, premature birth, peer problems and school readiness scores differentiated between specific ADHD symptom trajectories. CONCLUSIONS Taken together, our findings provide preliminary evidence that distinguishing different trajectories of ADHD symptoms could be clinically informative.
Collapse
Affiliation(s)
| | | | | | - Lara Carter
- Department of Psychology, University of Edinburgh, UK
| | - Daniel Mirman
- Department of Psychology, University of Edinburgh, UK
| | - Arthur Caye
- Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| | - Luis Rohde
- Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| |
Collapse
|
7
|
Early life predictors of attention deficit/hyperactivity disorder symptomatology profiles from early through middle childhood. Dev Psychopathol 2019; 32:791-802. [PMID: 31439070 DOI: 10.1017/s0954579419001135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study used repeated measures data to identify developmental profiles of elevated risk for ADHD (i.e., six or more inattentive and/or hyperactive-impulsive symptoms), with an interest in the age at which ADHD risk first emerged. Risk factors that were measured across the first 3 years of life were used to predict profile membership. Participants included 1,173 children who were drawn from the Family Life Project, an ongoing longitudinal study of children's development in low-income, nonmetropolitan communities. Four heuristic profiles of ADHD risk were identified. Approximately two thirds of children never exhibited elevated risk for ADHD. The remaining children were characterized by early childhood onset and persistent risk (5%), early childhood limited risk (10%), and middle childhood onset risk (19%). Pregnancy and delivery complications and harsh-intrusive caregiving behaviors operated as general risk for all ADHD profiles. Parental history of ADHD was uniquely predictive of early onset and persistent ADHD risk, and low primary caregiver education was uniquely predictive of early childhood limited ADHD risk. Results are discussed with respect to how changes to the age of onset criterion for ADHD in DSM5 may affect etiological research and the need for developmental models of ADHD that inform ADHD symptom persistence and desistance.
Collapse
|
8
|
Haslam D, Mejia A, Thomson D, Betancourt T. Self-Regulation in Low- and Middle-Income Countries: Challenges and Future Directions. Clin Child Fam Psychol Rev 2019; 22:104-117. [PMID: 30725308 DOI: 10.1007/s10567-019-00278-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Self-regulation is developed early in life through family and parenting interactions. There has been considerable debate on how to best conceptualize and enhance self-regulation. Many consider self-regulation as the socio-emotional competencies required for healthy and productive living, including the flexibility to regulate emotions, control anger, maintain calm under pressure, and respond adaptively to a variety of situations. Its enhancement is the focus of many child and family interventions. An important limitation of the self-regulation field is that most empirical and conceptual research comes from high-income countries (HICs). Less is known about the manifestation, measurement and role of self-regulation in many collectivistic, rural, or less-developed contexts such as low- and middle-income countries (LMICs). This position paper aims to present an initial review of the existing literature on self-regulation in LMICs, with a focus on parenting, and to describe challenges in terms of measurement and implementation of self-regulation components into existing interventions for parents, children and adolescents in these settings. We conclude by establishing steps or recommendations for conducting basic research to understand how self-regulation expresses itself in vulnerable and low-resource settings and for incorporating components of self-regulation into services in LMICs.
Collapse
Affiliation(s)
- Divna Haslam
- Parenting & Family Support Centre, The University of Queensland, Brisbane, Australia.
| | | | - Dana Thomson
- Boston College School of Social Work, Chestnut Hill, MA, USA
| | | |
Collapse
|
9
|
Caughy MO, Mills B, Brinkley D, Owen MT. Behavioral Self-Regulation, Early Academic Achievement, and the Effectiveness of Urban Schools for Low-Income Ethnic Minority Children. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 61:372-385. [PMID: 29603751 PMCID: PMC6023777 DOI: 10.1002/ajcp.12242] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The independent and joint associations between child behavioral self-regulation ability and school effectiveness in relation to academic achievement were examined in a sample of low-income African American (n = 132) and Latino (n = 198) children attending kindergarten and first grade across a large metropolitan area. Child behavioral self-regulation and school effectiveness were positively associated with both reading and mathematics performance. School effectiveness moderated the effect of behavioral self-regulation on reading but not math achievement. Lower child behavioral self-regulation during early elementary school was associated with lower reading achievement the following year but only among children attending less effective schools. Behavioral self-regulation was not related to reading achievement among children attending more effective schools. Implications of these findings for policies addressing disparities in early academic achievement are discussed.
Collapse
|
10
|
O'Neill S, Rajendran K, Mahbubani SM, Halperin JM. Preschool Predictors of ADHD Symptoms and Impairment During Childhood and Adolescence. Curr Psychiatry Rep 2017; 19:95. [PMID: 29082443 PMCID: PMC6349372 DOI: 10.1007/s11920-017-0853-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW This paper summarizes key, recently published research examining longitudinal outcomes for preschoolers with high levels of inattention and/or hyperactivity/impulsivity. RECENT FINDINGS Symptom trajectories show that hyperactivity/impulsivity declines across childhood. At the group level, the course of inattention appears more variable. However, identification of subgroups of children showing stable, rising, and falling inattention over time is promising. Early ADHD-like symptoms portend risk for academic and social difficulties, as well as comorbid emotional and behavioral problems in childhood and adolescence. Several early risk factors appear to moderate these relations, including comorbid symptoms, parental psychopathology, socioeconomic disadvantage, and perhaps neuropsychological dysfunction. Furthermore, high levels of inattention and/or hyperactivity/impulsivity during the preschool period appear to compromise development of regulatory and neuropsychological functions, which in turn increases risk for negative outcomes later in childhood. Identified risk factors are targets for novel interventions, which ideally would be delivered early to at-risk children.
Collapse
Affiliation(s)
- Sarah O'Neill
- The City College and The Graduate Center, City University of New York, New York, NY, USA.
- Department of Psychology, The City College and The Graduate Center, The City College of New York, 160 Convent Avenue, New York, NY, 10031, USA.
| | - Khushmand Rajendran
- Department of Social Sciences, Human Services and Criminal Justice, Borough of Manhattan Community College, City University of New York, New York, NY, USA
| | | | - Jeffrey M Halperin
- Department of Psychology, Queens College and The Graduate Center, City University of New York, Flushing, NY, USA
| |
Collapse
|
11
|
Strasser K, Rolla A, Romero-Contreras S. School Readiness Research in Latin America: Findings and Challenges. New Dir Child Adolesc Dev 2017; 2016:31-44. [PMID: 27254825 DOI: 10.1002/cad.20160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Educational results in Latin America (LA) are well below those of developed countries. One factor that influences how well children do at school is school readiness. In this article, we review studies conducted in LA on the readiness skills of preschool children. We begin by discussing contextual factors that affect what is expected of children upon school entry, and we examine critical aspects of children's developmental contexts in LA. We then review local research on the level and determinants of three readiness skills of preschoolers in LA. Few studies allow comparisons between LA and other regions, but some results suggest that the oral language of children in LA before school entry is lower than in developed countries. These entry-level differences do not seem large enough to explain the poor educational results obtained by children in LA. We conclude regarding research needed to explain educational results and to inform educational policies.
Collapse
|
12
|
Sasser TR, Kalvin CB, Bierman KL. Developmental trajectories of clinically significant attention-deficit/hyperactivity disorder (ADHD) symptoms from grade 3 through 12 in a high-risk sample: Predictors and outcomes. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 125:207-219. [PMID: 26854506 PMCID: PMC4747050 DOI: 10.1037/abn0000112] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Developmental trajectories of clinically significant attention-deficit/hyperactivity (ADHD) symptoms were explored in a sample of 413 children identified as high risk because of elevated kindergarten conduct problems. Symptoms of inattention and hyperactivity-impulsivity were modeled simultaneously in a longitudinal latent class analyses, using parent reports collected in Grades 3, 6, 9, and 12. Three developmental trajectories emerged: (1) low levels of inattention and hyperactivity (low), (2) initially high but then declining symptoms (declining), and (3) continuously high symptoms that featured hyperactivity in childhood and early adolescence and inattention in adolescence (high). Multinomial logistic regressions examined child characteristics and family risk factors as predictors of ADHD trajectories. Relative to the low class, children in the high and declining classes displayed similar elevations of inattention and hyperactivity in early childhood. The high class was distinguished from the declining class by higher rates of aggression and hyperactivity at school and emotion dysregulation at home. In contrast, the declining class displayed more social isolation at home and school, relative to the low class. Families of children in both high and declining trajectory classes experienced elevated life stressors, and parents of children in the high class were also more inconsistent in their discipline practices relative to the low class. By late adolescence, children in the high class were significantly more antisocial than those in the low class, with higher rates of arrests, school dropout, and unemployment, whereas children in the declining class did not differ from those in the low trajectory class. The developmental and clinical implications of these findings are discussed.
Collapse
Affiliation(s)
- Tyler R Sasser
- Department of Psychology, The Pennsylvania State University
| | | | | |
Collapse
|