Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep;2(3):e12099.
doi: 10.1002/jcv2.12099. Epub 2022 Sep 2.

Preschool development, temperament and genetic liability as early markers of childhood ADHD: A cohort study

Esther Tobarra-Sanchez  1   2 , Lucy Riglin  1 , Sharifah S Agha  1   2 , Evie Stergiakouli  3   4 , Anita Thapar  1 , Kate Langley  1   5
Affiliations

Preschool development, temperament and genetic liability as early markers of childhood ADHD: A cohort study

Esther Tobarra-Sanchez et al. JCPP Adv. 2022 Sep.

Abstract

Background: ADHD is associated with multiple adverse outcomes and early identification is important. The present study sets out to identify early markers and developmental characteristics during the first 30 months of life that are associated with ADHD 6 years later.

Methods: 9201 participants from the prospective Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were included. Outcome measures were parent-rated ADHD symptom scores (Strengths and Difficulties Questionnaire, SDQ) and ADHD diagnosis (Development and Wellbeing Assessment, DAWBA) at age 7. Seventeen putative markers were identified from previous literature and included: pre- and peri-natal risk factors, genetic liability (ADHD polygenic risk scores, PRS), early development, temperament scores and regulatory problems. Associations were examined using regression analysis.

Results: Univariable regression analysis showed that multiple early life factors were associated with future ADHD outcomes, even after controlling for sex and socio-economic status. In a multivariable linear regression model; temperament activity scores (B = 0.107, CI = 0.083-0.132), vocabulary delay (B = 0.605, CI = 0.211-0.988), fine motor delay (B = 0.693, CI = 0.360-1.025) and ADHD PRS (B = 0.184, CI = 0.074-0.294) were associated with future symptoms (R 2 = 10.7%). In a multivariable logistic regression model, ADHD PRS (OR = 1.39, CI = 1.10-1.77) and temperament activity scores (OR = 1.09, CI = 1.04-1.16) showed association with ADHD diagnosis.

Conclusion: As well as male sex and lower socio-economic status, high temperament activity levels and motor and speech delays in the first 30 months of life, are associated with childhood ADHD. Intriguingly, given that genetic risk scores are known to explain little of the variance of ADHD outcomes, we found that ADHD PRS added useful predictive information. Future research needs to test whether predictive models incorporating aspects of early development and genetic risk scores are useful for predicting ADHD in clinical practice.

Keywords: ADHD; ALSPAC; developmental delay; early markers; polygenic risk scores; precursors; temperament.

PubMed Disclaimer

Conflict of interest statement

The authors declares that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Aagaard, K. , Bach, C. C. , Henriksen, T. B. , Larsen, R. T. , & Matthiesen, N. B. (2018). Head circumference at birth and childhood developmental disorders in a nationwide cohort in Denmark. Paediatric & Perinatal Epidemiology, 32(5), 458–466. 10.1111/ppe.12479 - DOI - PubMed
    1. Arnett, A. B. , Macdonald, B. , & Pennington, B. F. (2013). Cognitive and behavioral indicators of ADHD symptoms prior to school age. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 54(12), 1284–1294. - PMC - PubMed
    1. Athanasiadou, A. , Buitelaar, J. K. , Brovedani, P. , Chorna, O. , Fulceri, F. , Guzzetta, A. , & Scattoni, M. L. (2020). Early motor signs of attention‐deficit hyperactivity disorder: A systematic review. European Child & Adolescent Psychiatry, 29(7), 903–916. - PMC - PubMed
    1. Baumann, N. , Jaekel, J. , Breeman, L. , Bartmann, P. , Bäuml, J. G. , Avram, M. , Sorg, C. , & Wolke, D. (2019). The association of infant crying, feeding, and sleeping problems and inhibitory control with attention regulation at school age. Infancy, 24(5), 768–786. - PubMed
    1. Boyd, A. , Golding, J. , Macleod, J. , Lawlor, D. A. , Fraser, A. , Henderson, J. , Molloy, L. , Ness, A. , Ring, S. , & Davey‐Smith, G. (2013). Cohort profile: The ‘children of the 90s’; the index offspring of The Avon Longitudinal Study of Parents and Children (ALSPAC). International Journal of Epidemiology, 42(1), 111–127. - PMC - PubMed