Early Predictors of Attention-Deficit/ Hyperactivity Disorder and School Difficulties in Low-Birthweight,Premature Children

Abstract

This study investigated whether specific behaviors observed in 30 month-old lowbirthweight children are predictive of diagnosis of attention-deficit/hyperactivity disorder (ADHD) and school difficulties at age 8. Videotapes of 571 participants were coded using the Attention-Deficit Hyperactivity Disorder Observational Rating Scale (ADHD-ORS). Logistic and discriminant analyses were conducted using the three scale factors. High scores on one factor, Inattentiveness, predicted physician diagnosis and/or school difficulties 5¹ 2 years later. The Inattentiveness factor also discriminated a linear sequence of diagnostic groups, two of which were statistically significant. These findings suggest that certain behaviors can be identified before the age of 3 by trained observers and that this identification that make a future ADHD diagnosis and/or school difficulties more likely.

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References

Alessandri, S.M. (1992). Attention, play, and social behavior in preschoolers . Journal of Abnormal Child Psychology, 20, 289—302.

American Academy of Pediatrics. (2001). Diagnosis and evaluation of the child with Attention-Deficit/Hyperactivity Disorder (AC0002). Pediatrics, 105, 1158—1170

American Psychiatric Association. (1994). Diagnostic and statistical manual for mental disorders (4th ed.). Washington, DC: Author .

Barkley, R.A. (1990). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford Press.

Barkley, R.A. , Fischer, M.E. , Edelbrock, C.S. , & Smallish, L. (1989). The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 546—557.

Biederman, J. , Newcorn, J. , & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, and other disorders. The American Journal of Psychiatry, 148, 564—577.

Biederman, J. , Mick, E. , & Farone, S.V. (2000). Age-dependent decline of symptoms of attention deficit hyperactivity disorder: Impact of remission definition and symptom type. The American Journal of Psychiatry, 157, 816—818.

Blackman, J.A. (1999). Attention-deficit/hyperactivity disorder in preschoolers. Does it exist and should we treat it? Pediatric Clinics of North America, 46, 1011—1025.

Botting, N. , Powls, A. , Cooke, R.W.I. , & Marlow, N. (1997). Attention deficit hyperactivity disorders and other psychiatric outcomes in very low birth-weight children at 12 years. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 38, 931—941.

10.

Campbell, S.B. (1995). Behavior problems in preschool children: A review of recent research. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 36, 113—149.

11.

Campbell, S.B. , Breaux, A.M. , Ewing, L.J. , & Szumowski, E.K. (1984). A One-Year Follow-up Study of Parent-referred Hyperactive Preschool Children. Journal of the American Academy of Child Psychiatry, 23, 243—249.

12.

Campbell, S.B. , Breaux, A.M. , Ewing, L.J. , & Szumowski, E.K. (1986). Correlates and predictors of hyperactivity and aggression: A longitudinal study of parent-referred problem preschoolers. Journal of Abnormal Child Psychology, 14, 217—234.

13.

Campbell, S.B. , Pierce, E.W. , March, C.L. , Ewing, L.J. , & Szumowski, E.K. (1994). Hard-to-manage preschool boys: Symptomatic behavior across contexts and time. Child Development, 65, 836—851.

14.

Campbell, S.B. , Szumowski, E.K. , Ewing, L.J. , Gluck, D. , & Breaux, A.M. (1982). A multidimensional assessment of parent-identified behavior problem toddlers. Journal of Abnormal Child Psychology , 10, 569—592.

15.

Chan, E. , Zhan, C. , & Homer, C. (2002). Health care use and costs for children with attention-deficit/hyperactivity disorder. Archives of Pediatrics & Adolescent Medicine , 156, 504—511.

16.

Cherkes-Julkowski, M. (1998). Learning disability, attention-deficit disorder, and language impairment as outcomes of prematurity: A longitudinal descriptive study. Journal of Learning Disabilities, 31, 294—306.

17.

Connor, D.F. (2002). Preschool attention deficit hyperactivity disorder: a review of prevalence, diagnosis, neurobiology and stimulant treatment. Journal of Developmental and Behavioral Pediatrics, 23, 1—7.

18.

Deutscher, B. , & Fewell, R.R. (1996). The attention-deficit hyperactivity disorder observational rating scale (ADHD-ORS). Unpublished scale, The Debbie Institute, University of Miami School of Medicine, Miami, FL.

19.

Deutscher, B. , & Fewell, R.R. (2001). The development and use of the attention-deficit hyperactivity disorder-observational rating scale: Factor analysis and preliminary investigation of predictive validity. Journal of Psychoeducational Assessment, 19, 317—333.

20.

DuPaul, G.J. , & Stoner, G. (1993). ADHD and learning difficulties: What is the connection? In ADHD in the schools: Assessment and intervention strategies (pp. 62—95). New York: Guilford Press.

21.

DuPaul, G.J. , McGoey, K.E. , Eckert, T.L. , & Van Brakle, J. (2001). Preschool children with attention-deficit/hyperactivity disorder: Impairments in behavioral, social, and school functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 508—515.

22.

Fewell, R.R. , & Deutscher, B. (2002). Attention deficit hyperactivity disorder in very young children: Early signs and interventions. Infants and Young Children, 14, 24—32.

23.

Fewell, R.R. , & Deutscher, B. (2004). Contributions of early language and maternal facilitation variables to later language and reading abilities. Journal of Early Intervention, 26, 132—145.

24.

Gelfand, D.M. , & Hartman, D.P. (1975). Child behavior analysis and therapy. Elmsford, NY: Pergamon Press.

25.

Gittleman, R. , Mannuzza, S. , Shenker, R. , & Bonagura, N. (1985). Hyperactive boys almost grown-up: Psychiatric status. General Psychiatry, 42, 937—947.

26.

Greenhill, L. (1998). The use of psychotropic medication in preschoolers: Indications, safety, and efficacy. Canadian Journal of Psychiatry , 13, 576—581.

27.

Hart, E.L. , Lahey, B.B. , Loeber, R. , Applegate, B. , & Frick, P.J. (1995). Developmental change in attention-deficit hyperactivity disorder in boys: A four-year longitudinal study. Journal of Abnormal Child Psychology, 23, 729—749.

28.

Hollomon, H.A. , & Scott, K.G. (1998). Influence of birth weight on educational outcomes at age 9: The Miami site of the Infant Health and Development Program. Journal of Developmental and Behavioral Pediatrics, 19, 404—410.

29.

Hoy, E.A. , Bill, J.M. , & Sykes, D.H. (1988). Very low birthweight: A long-term developmental impairment? International Journal of Behavioral Development , 11, 37—67.

30.

Infant Health and Development Program. (1990 ). Enhancing the outcomes of low birthweight, premature infants . Journal of the American Medical Association, 263(23), 3035—3042.

31.

Kelleher, K.J. , McInery, T.K. , Gardner, W.P. , Childs, G.E. , & Wasserman, R.C. (2000). Increasing identification of psychosocial problems: 1979—1996. Pediatrics, 105, 1313—1321.

32.

Klein, N.K. , Hack, M. , & Breslau, N. (1989). Children who were very low-birth-weight: Development and academic achievement at nine years of age. Journal of Developmental and Behavioral Pediatrics, 10, 32—37

33.

Loney, J. , & Milich, R. (1982). Hyperactivity, inattention, and aggression in clinical practice. In D. Routh & M. Wolraich (Eds.), Advances in developmental and behavioral pediatrics (Vol. 3, pp. 113—147). Greenwich, CT: JAI Press.

34.

McCarton, C.M. , Brooks-Gunn, J. , Wallace, I.F. , Bauer, C.R. , Bennett, F.C. , & Bernbaum, J.C. (1997). Results at age 8 years of early intervention for low-birthweight premature infants. Journal of the American Medical Association, 277, 126—131.

35.

McKinney, J.D. , Montague, M. , & Hocutt, A.M. (1993). Synthesis of research on the assessment and identification of students with attention deficit disorder. University of Miami, OSEP Grant HO23S10013.

36.

Mick, E. , Biederman, J. , Prince, J. , Fischer, M.J. , & Farone, S.V. (2002). Impact of low birth weight on attention-deficit hyperactivity disorder. Journal of Developmental and Behavioral Pediatrics, 23, 16—22.

37.

National Institutes of Health. (1998). Diagnosis and treatment of attention deficit hyperactivity disorder. NIH Consensus Statement, 16(2), 1—37.

38.

Ornoy, A. , Uriel, L. , & Tennenbaum, A. (1992). Inattention, hyperactivity and speech delay at 2-4 years of age as a predictor for ADD-ADHD Syndrome. Israeli Journal of Psychiatry and Related Sciences, 30, 155—161.

39.

Palfrey, J.S. , Levine, M.D. , Walker, D.K. , & Sullivan, M. (1985). The emergence of attention deficits in early childhood: A prospective study. Journal of Developmental and Behavioral Pediatrics, 6, 339— 348.

40.

Rappley, M.D. , Mullan, P.B. , Alvarez, F.J. , Eneli, I.U. , Wang, J. , & Gardiner, J.C. (1999). Diagnosis of attention-deficit/hyperactivity disorder and use of psychotropic medication in very young children. Archives of Pediatrics & Adolescent Medicine, 153, 1039—1045.

41.

Sanson, A. , Smart, D. , Prior, M. , & Oberklaid, F. (1993). Precursors of hyperactivity and aggression. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 1207—1216.

42.

Spiker, D. , Ferguson, J. , & Brooks-Gunn, J. (1993). Enhancing maternal interactive behavior and child social competence in low birthweight, premature infants . Child Development, 64, 754—768.

43.

Zito, J.M. , Safer, D.J. , dosReis, S. , Gardner, J.F. , Boles, M. , & Lynch, F. (2000). Trends in the prescribing of psychotropic medications to preschoolers. Journal of the American Medical Association , 283, 1025—1030.