Three year outcomes in infants with a family history of autism and/or attention deficit hyperactivity disorder.
Three year outcomes in infants with a family history of autism and/or attention deficit hyperactivity disorder.
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患有自闭症和/或注意力缺陷多动障碍的婴儿的婴儿三年结局。
作者：
大多数关于有自闭症家族史 (FH) 的婴儿早期结局的研究都集中在明确定义的自闭症上，尽管有些婴儿存在语言和发育迟缓。对于注意力缺陷多动障碍 (ADHD) FH 婴儿的结局知之甚少。患有或不患有自闭症和/或多动症的 FH 的婴儿，由于一级亲属患有其中一种或两种疾病，在 5 个月或 10 个月时被招募。使用潜在概况分析（LPA）对认知能力、适应性功能和自闭症、多动症和焦虑特征等指标进行了三年结果的表征（n = 131）。我们还仅使用自闭症和多动症指标进行了 LPA，并在独立队列 (n = 139) 和两个队列的组合 (n = 270) 中进行了更广泛的 LPA。低发育水平+高行为问题班级的自闭症、注意力缺陷多动症和焦虑评分较高，认知和适应功能较低，除了一名患有自闭症的孩子外，其他所有人都患有自闭症。低发育水平+典型行为类别具有平均认知能力和典型行为，但适应功能较低。典型发展水平+一些行为问题班级的认知和适应功能平均，但行为分数略有升高。高发展水平+典型行为类别具有高于平均水平的认知能力和典型行为。所有四个 LPA 都确定了具有低发展水平和高行为分数之一或两者组合的特征的类别，以及典型的发展类别。没有哪个班级的自闭症或多动症特征是单独升高的。一些患有自闭症或多动症 FH 的婴儿具有非典型的发育和行为结果，但单独表现出强烈的自闭症或多动症特征。该领域需要重新调整目标和方法，以接受在这些婴儿中看到的更广泛的跨诊断结果模式。我们使用了广泛的结果测量来确定有自闭症或多动症家族史的婴儿早期非典型结果的“自然类别”。一些有自闭症或多动症家族史的婴儿的神经发育特征是低发育水平和非典型行为中的一种或两种的组合，而不是孤立的自闭症或多动症特征升高。该领域需要采用跨诊断方法来研究自闭症和多动症的早期发展，以开发适合目的的发展模型和转化机会。
Most research on early outcomes in infants with a family history (FH) of autism has focussed on categorically defined autism, although some have language and developmental delays. Less is known about outcomes in infants with a FH of attention deficit hyperactivity disorder (ADHD). Infants with and without a FH of autism and/or ADHD, due to a first‐degree relative with either or both conditions, were recruited at 5 or 10 months. Three year outcomes were characterised using latent profile analysis (LPA) across measures of cognitive ability, adaptive functioning and autism, ADHD and anxiety traits (n = 131). We additionally ran an LPA using only autism and ADHD measures, and the broader LPA in an independent cohort (n = 139) and in both cohorts combined (n = 270). A Low Developmental Level + High Behavioural Concerns class had elevated autism, ADHD and anxiety scores, low cognitive and adaptive function, and included all but one child with autism. A Low Developmental Level + Typical Behaviour class had average cognitive ability and typical behaviour but low adaptive function. A Typical Developmental Level + Some Behavioural Concerns class had average cognitive and adaptive function but slightly elevated behaviour scores. A High Developmental Level + Typical Behaviour class had above average cognitive ability and typical behaviour. All four LPAs identified classes characterised by combinations of either, or both, Low Development Level and elevated behaviour scores, as well as a typically developing class. No classes had elevated autism or ADHD traits in isolation. Some infants with a FH of autism or ADHD have atypical developmental and behavioural outcomes, but do not show strong autism or ADHD traits in isolation. The field needs to recalibrate aims and methods to embrace the broader transdiagnostic pattern of outcomes seen in these infants. We used a broad range of outcome measures to identify the ‘natural categories’ of early atypical outcome in infants with family history of autism or ADHD. Some infants with a family history of autism or ADHD have neurodevelopmental profiles characterised by combinations of either, or both, low developmental level and atypical behaviour but not elevated autism or ADHD traits in isolation. The field needs to adopt a transdiagnostic approach in the study of early development in autism and ADHD in order to develop fit‐for‐purpose developmental models and translational opportunities.