ADHD at age 7 and functional impairments at age 10
Efron, D; Nicholson, JM; Anderson, V; et al.Silk, T; Ukoumunne, OC; Gulenc, A; Hazell, P; Jongeling, B; Sciberras, E
Date: 2 November 2020
Journal
Pediatrics
Publisher
American Academy of Pediatrics
Publisher DOI
Abstract
Background and Objectives
Attention-Deficit/Hyperactivity Disorder (ADHD) cohort studies have typically involved
clinical samples, and have usually recruited children across wide age ranges, limiting
generalizability across complexity and developmental stage. We compared academic,
emotional-behavioral and social functioning at age ...
Background and Objectives
Attention-Deficit/Hyperactivity Disorder (ADHD) cohort studies have typically involved
clinical samples, and have usually recruited children across wide age ranges, limiting
generalizability across complexity and developmental stage. We compared academic,
emotional-behavioral and social functioning at age 10, and predictors of outcomes, in a nonreferred cohort of children recruited at age 7, between full syndrome (FS) ADHD,
subthreshold (ST) ADHD and non-ADHD controls.
Methods
This was a prospective, cohort study with a 3 year follow-up period. Children were recruited
from 43 socio-economically diverse schools in Melbourne, Australia. Multi-informant
outcomes at age 10 were academic functioning (Wide Range Achievement Test-4; Social
Skills Improvement System), emotional-behavioral functioning (Strengths and Difficulties
Questionnaire (SDQ) Total)) and social functioning (SDQ Peer Problems). Outcomes were
compared across the groups using adjusted random effects linear regression analyses.
Results
477 children (62% male) were recruited at mean (SD) age 7.3 years (0.4). There were 179 FS
participants, 86 ST and 212 controls. Sample retention was 78.2% at 3-year follow-up. Both
the FS and ST groups were functioning worse than controls on almost all outcome measures.
The best predictors of outcome for children with ADHD were working memory (academic
outcome, p<0.001), ADHD symptom severity (emotional-behavioral outcome, parent: p
<0.001, teacher: p<0.01), and autism spectrum disorder symptoms (emotional-behavioral
outcome, parent p=0.003; social outcome, parent p=0.001).
Conclusions
Children with FS and ST ADHD at age 7 experience persisting functional impairments across
domains at age 10. The predictors identified at age 7 present potential targets for intervention
to ameliorate impairments.
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