A Longitudinal Study of Attention-Deficit/Hyperactivity Disorder Symptoms in Preschool-Age Children

Attention-deficit hyperactivity disorder (ADHD) is among the most common reasons for referral to children\u27s mental health clinics, with an estimated prevalence of 3% to 5% in the general population of school-age children. Children who exhibit the requisite behaviors may obtain a diagnosis of ADHD at any age; however, symptom onset must occur before age 7 and persist for at least 6 months. Despite these temporal requirements for diagnosis, little empirical information about the manifestation and stability of ADHD symptoms in preschool children exists. This study provides information about the initial presence and stability over one academic year of ADHD behaviors in a sample of 290 preschool children rated by mothers and/or teachers. Data suggest higher levels of these behaviors at home versus school, with behaviors remaining stable over the course of the academic year at school, and diminishing over this time period at home. Family environment factors (e.g., socioeconomic status, family stress) were not found to have strong predictive relationships with levels of ADHD behaviors in this sample of preschoolers including little support for a directional relationship between dysfunctional parenting behaviors and child ADHD symptoms. Conclusions and clinical implications of these finding, are provided and may assist psychologists in their efforts to diagnose and treat this disorder in young children

Parenting-related stress and psychological distress in mothers of toddlers with autism spectrum disorders

Parents of children with autism spectrum disorders (ASDs) are at risk for higher stress levels than parents of children with other developmental disabilities and typical development. Recent advances in early diagnosis have resulted in younger children being diagnosed with ASDs but factors associated with parent stress in this age group are not well understood

Developmental Change in the ERP Responses to Familiar Faces in Toddlers With Autism Spectrum Disorders Versus Typical Development: Developmental Change in the ERP Responses to Familiar Faces

Individuals with ASD show differences in face processing abilities from early in development. To examine whether these differences reflect an atypical versus delayed developmental trajectory, neural responses to familiar and unfamiliar faces in 24 18-to 47-month-old children with ASD were compared to responses of 32 12- to 30-month-old typically developing children. Results of two experiments revealed that neural responses to faces in children with ASD resembled those observed in younger typically developing children, suggesting delayed development. Electrophysiological responses to faces were also related to parent-report of adaptive social behaviors for both children with ASD and typical development. Slower development of the face processing system in ASD may be related to reduced self-directed ‘expected’ experience with faces in early development

The Impact of Parent-Delivered Intervention on Parents of Very Young Children with Autism

This study investigated the impact of a parent-coaching intervention based on the Early Start Denver Model (P-ESDM) on parenting-related stress and sense of competence. This was part of a multisite, randomized trial comparing P-ESDM (n=49) with community intervention (n=49) for children aged 12 and 24 months. The P-ESDM group reported no increase in parenting stress, whereas the Community group experienced an increase over the same 3-month period. Parental sense of competence did not differ. Number of negative life events was a significant predictor of parenting stress and sense of competence across both groups. This suggests that a parent-coaching intervention may help maintain parental adjustment directly after a child is diagnosed with ASD

Early Behavioral Intervention Is Associated With Normalized Brain Activity in Young Children With Autism

A previously published randomized clinical trial indicated that a developmental behavioral intervention, the Early Start Denver Model (ESDM), resulted in gains in IQ, language, and adaptive behavior of children with autism spectrum disorder. This report describes a secondary outcome measurement from this trial, EEG activity

Factor Structure of DSM-IV Attention Deficit-Hyperactivity Symptoms: A Confirmatory Factor Analysis of the ADHD-SRS

Since the inception of DSM-IV considerable research has focused on the conceptualization of attention deficit-hyperactivity disorder (ADHD) as a multidimensional construct. This study utilized confirmatory factor analysis (CFA) to examine the adequacy of fit for the two-factor model (hyperactivity/impulsivity and inattention) previously specified for the ADHD Symptoms Rating Scale (ADHD-SRS), Parent Version. The invariance of this model across gender was then examined using a second, independent sample of children. The results indicate that a two-factor model provides the best fit for the data using the ADHD-SRS. Additionally, findings suggested that this model is invariant across gender. These results provide support both for the psychometric properties of the ADHD-SRS and the subtypes of ADHD specified in the DSM-IV

Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder.

ObjectiveWe prospectively examined evidence for the sustained effects of early intervention based on a follow-up study of 39 children with ASD who began participation in a randomized clinical trial testing the effectiveness of the Early Start Denver Model (ESDM) at age 18 to 30 months. The intervention, conducted at a high level of intensity in-home for 2 years, showed evidence of efficacy immediately posttreatment.MethodThis group of children was assessed at age 6 years, 2 years after the intervention ended, across multiple domains of functioning by clinicians naive to previous intervention group status.ResultsThe ESDM group, on average, maintained gains made in early intervention during the 2-year follow-up period in overall intellectual ability, adaptive behavior, symptom severity, and challenging behavior. No group differences in core autism symptoms were found immediately posttreatment; however, 2 years later, the ESDM group demonstrated improved core autism symptoms and adaptive behavior as compared with the community-intervention-as-usual (COM) group. The 2 groups were not significantly different in terms of intellectual functioning at age 6 years. Both groups received equivalent intervention hours during the original study, but the ESDM group received fewer hours during the follow-up period.ConclusionThese results provide evidence that gains from early intensive intervention are maintained 2 years later. Notably, core autism symptoms improved in the ESDM group over the follow-up period relative to the COM group. This improvement occurred at the same time that the ESDM group received significantly fewer services. This is the first study to examine the role of early ESDM behavioral intervention initiated at less than 30 months of age in altering the longer-term developmental course of autism

Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder.

ObjectiveWe prospectively examined evidence for the sustained effects of early intervention based on a follow-up study of 39 children with ASD who began participation in a randomized clinical trial testing the effectiveness of the Early Start Denver Model (ESDM) at age 18 to 30 months. The intervention, conducted at a high level of intensity in-home for 2 years, showed evidence of efficacy immediately posttreatment.MethodThis group of children was assessed at age 6 years, 2 years after the intervention ended, across multiple domains of functioning by clinicians naive to previous intervention group status.ResultsThe ESDM group, on average, maintained gains made in early intervention during the 2-year follow-up period in overall intellectual ability, adaptive behavior, symptom severity, and challenging behavior. No group differences in core autism symptoms were found immediately posttreatment; however, 2 years later, the ESDM group demonstrated improved core autism symptoms and adaptive behavior as compared with the community-intervention-as-usual (COM) group. The 2 groups were not significantly different in terms of intellectual functioning at age 6 years. Both groups received equivalent intervention hours during the original study, but the ESDM group received fewer hours during the follow-up period.ConclusionThese results provide evidence that gains from early intensive intervention are maintained 2 years later. Notably, core autism symptoms improved in the ESDM group over the follow-up period relative to the COM group. This improvement occurred at the same time that the ESDM group received significantly fewer services. This is the first study to examine the role of early ESDM behavioral intervention initiated at less than 30 months of age in altering the longer-term developmental course of autism

An exploratory longitudinal study of social and language outcomes in children with autism in bilingual home environments

Little is known about outcomes of early intervention for children with autism spectrum disorder reared in bilingual homes. There are concerns that social communication deficits among children with autism spectrum disorder may reduce the developmental benefits of early intervention for children with autism spectrum disorder raised in bilingual environments. We conducted an exploratory analysis of cross-sectional and longitudinal data from a larger study to explore associations between home language environment and language ability and social skills in response to early autism spectrum disorder intervention. Participants, aged 12-26 months when recruited, were a subset of a larger 2-year, randomized intervention trial (ClinicalTrials.gov identifier: NCT00698997). Children from bilingual homes ( n = 13) began intervention with lower gesture use but otherwise demonstrated equal baseline language and social abilities as compared with age and nonverbal IQ-matched children from monolingual homes ( n = 24). Significant language growth was exhibited by children from both language groups and there was no moderating effect of home language environment. The bilingual home group demonstrated increased gesture use over the course of intervention as compared with the monolingual home group. Preliminary data revealed no basis for concerns regarding negative impact of a bilingual home environment on language or social development in young children with autism spectrum disorder

Sleep Problems and Trajectories of Restricted and Repetitive Behaviors in Children with Neurodevelopmental Disabilities.

Sleep problems are prevalent in children with neurodevelopmental disabilities and are associated with the expression of restricted and repetitive behaviors (RRBs). Children (n = 57) with autism spectrum disorder (ASD, n = 38) or developmental delay (DD, n = 19) participated in multiple assessments of intellectual ability, ASD symptoms, and RRBs (3 timepoints for ASD, 2 for DD). Sleep problems assessed at age 4 via parent report were associated with trajectories of higher-order RRBs (sameness/ritualistic/compulsive behaviors) from age 2-6 in the ASD group, and from age 2-4 in the DD group, even after controlling for intellectual ability, social-affective symptoms, and anxiety. Trajectories of stereotyped/restricted behaviors were unrelated to sleep problems. Sleep problems were associated with trajectories of higher-order (but not lower-order) RRBs in a transdiagnostic sample