Miller Meghan, Orme Monica, Piergies Antonia, Iosif Ana-Maria, Ozonoff Sally
Department of Psychiatry & Behavioral Sciences, University of California.
MIND Institute, University of California.
J Clin Child Adolesc Psychol. 2025 Jul 23:1-10. doi: 10.1080/15374416.2025.2534939.
We evaluated the stability of attention-deficit/hyperactivity (ADHD) symptoms from the toddler (24 months of age) to the preschool period (36-64 months of age) in a sample enriched for varied neurodevelopmental risk to ensure a range of ADHD symptoms.
Participants ( = 256) included infants with a family history of ADHD ( = 66), autism ( = 115), or neither ( = 75) who were prospectively followed over the first several years of life. At 24 and 36-64 months of age, parents completed the Preschool ADHD Rating Scale. At the preschool visit, children were classified into one of three mutually exclusive outcome groups: ADHD Concerns (i.e. elevated symptoms, clinician concern), Autism, or Comparison. ADHD symptom stability from the toddler to the preschool period was assessed, along with variability in early symptoms and change over time by preschool clinical presentation.
Symptoms were moderately stable, with summary score correlations of 0.56-0.60. Total scores were significantly higher at 24 months among those with later concerns for ADHD or diagnoses of autism, and increased in these two groups over time, but decreased in the Comparison group.
Symptom measurement at age 2 may be useful for identifying toddlers at higher risk for later behavioral challenges, with implications for early screening. Future work in this area can help delineate boundaries of developmental typicality versus atypicality, evaluate the specificity of early symptom elevations to longer-term outcomes, and identify patterns of symptom stability from the toddler period over time that may aid in identifying children at greatest risk for persistent/increasing challenges.
我们在一个因各种神经发育风险而丰富的样本中，评估了注意力缺陷/多动障碍（ADHD）症状从幼儿期（24个月龄）到学龄前期（36 - 64个月龄）的稳定性，以确保有一系列ADHD症状。
参与者（n = 256）包括有ADHD家族史（n = 66）、自闭症家族史（n = 115）或无家族史（n = 75）的婴儿，他们在生命的最初几年被前瞻性地跟踪随访。在24个月以及36 - 64个月龄时，家长完成《学龄前期ADHD评定量表》。在学龄前期访视时，儿童被分为三个相互排斥的结局组之一：ADHD相关问题（即症状升高，临床医生关注）、自闭症或对照组。评估了从幼儿期到学龄前期ADHD症状的稳定性，以及早期症状的变异性和随时间根据学龄前期临床表现的变化。
症状具有中等稳定性，汇总得分的相关性为0.56 - 0.60。在后来有ADHD相关问题或自闭症诊断的儿童中，24个月时的总分显著更高，且这两组随时间增加，但对照组则下降。
2岁时的症状测量可能有助于识别后期有行为挑战风险较高的幼儿，这对早期筛查有启示意义。该领域未来的工作有助于界定发育典型性与非典型性的界限，评估早期症状升高对长期结局的特异性，并确定从幼儿期随时间推移的症状稳定性模式，这可能有助于识别面临持续/增加挑战风险最大的儿童。
