Development matters: Characterizing patterns of emergent ADHD risk through a neurodevelopmental framework

发展很重要：通过神经发育框架表征 ADHD 突发风险的模式

• 批准号: 10678400
• 负责人: Amanda Nili
• 金额: $ 8.85万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-23 至 2024-06-22
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10678400
• 关键词: 5 year old; Accounting; Address; Age; Age Months; Attention; Attention deficit hyperactivity disorder; Award; Behavior; Behavioral; Caregiver well-being; Child; Chronic; Clinical; Collection; Communities; Data; Data Collection; Development; Dimensions; Disease; Disparity; Early Intervention; Equation; Equity; Ethnic Origin; Ethnic Population; Goals; Grouping; Growth; Impairment; Individual; Inequity; Intervention Studies; Investigation; Link; Literature; Measurement; Measures; Mental Health; Mentors; Methods; Modeling; Nursery Schools; Outcome; Parents; Pathway interactions; Pattern; Phase; Population; Prevalence; Proxy; Psychopathology; Race; Regulation; Reporting; Research; Research Personnel; Resources; Risk; Risk Assessment; Risk Factors; Risk Marker; Role; Sampling; Sampling Studies; School-Age Population; Specific qualifier value; Standardization; Structural Models; Surveys; Symptoms; Syndrome; Testing; Time; Toddler; Training; Well Child Visits; Work; adverse childhood events; base; clinical application; clinical predictors; clinical translation; data modeling; diagnostic criteria; early childhood; early onset disorder; health disparity; health inequalities; innovation; mental set; multilevel analysis; novel; predictive modeling; protective factors; racial diversity; racial minority population; recruit; risk prediction model; skills; sociodemographics; tool

Project Summary Attention deficit/hyperactivity disorder (ADHD) is a prevalent and impairing early childhood disorder that presents notable challenges to normative development and can be reliably identified starting at preschool age, with risk captured as early as toddler age when employing developmentally based assessments. Identification of concerning attention dysregulation development, before frank disorder presents, could ameliorate negative cascades associated with emergent ADHD syndromes and impairment. Further, recent research points to pervasive, early onsetting mental health inequities, evident in patterns of emergent ADHD, and the need for equitable assessment to reduce bias in predictive risk modeling (i.e., accounting for protective factors in addition to risks, modeling specific risk indicators, rather than taking race as a proxy thereof). Thus, the current project seeks to characterize developmental change and its sociodemographic context in patterns of attention (dys)regulation across toddlerhood with outcomes at preschool age. This work draws on novel, clinically translatable research tools capturing the typical:atypical spectrum of neurodevelopmental and behavioral indicators of attention (dys)regulation: parent survey and standardized clinical observation. The project engages a community-based sample of children recruited at their first annual well-child visits and oversampled for psychopathology risk (i.e., irritability). Initial examination of outcomes at later timepoints indicates that the sample is well characterized for ADHD symptoms with prevalence matching other community samples. Under this award, I will train in innovative methods of longitudinal modeling (i.e., multilevel and group-based trajectory modeling) to generate models of data collected densely at toddler age, predicting developmental patterns to emergent ADHD outcomes at preschool age(3-5 years). In alignment with an equitable assessment approach, structural equation models examining structural and familial risks and protective factors will more richly characterize pathways to emergent ADHD symptoms at preschool age. This project seeks to characterize neurodevelopmental vulnerability to ADHD at the earliest point in the developmental sequence, establishing an empirically grounded, equitable approach to assessment and conceptualization of early risk.

项目概要 注意力缺陷/多动障碍 (ADHD) 是一种普遍存在的损害性幼儿期疾病， 对规范发展提出了显着的挑战，并且可以从学龄前开始可靠地识别， 当采用基于发育的评估时，早在幼儿时期就捕获了风险。鉴别 在明显的障碍出现之前，关注注意力失调的发展可以改善负面影响 与新出现的 ADHD 综合征和损伤相关的级联反应。此外，最近的研究指出 普遍存在的、早期发生的心理健康不平等现象，在突发多动症的模式中很明显，并且需要 公平评估，以减少预测风险模型中的偏差（即考虑到保护因素） 除了风险之外，还对特定的风险指标进行建模，而不是将种族作为其代理）。因此，当前 项目旨在以关注模式来描述发展变化及其社会人口背景 整个幼儿期的（失调）调节与学龄前的结果。这项工作借鉴了新颖的临床 可转化的研究工具捕捉典型：神经发育和行为的非典型谱 注意力（失调）调节指标：家长调查和标准化临床观察。项目 参与以社区为基础的儿童抽样调查，这些儿童是在第一次年度儿童健康访问中招募的，并进行了过度抽样 精神病理学风险（即烦躁）。对稍后时间点结果的初步检查表明 样本的 ADHD 症状得到了很好的表征，其患病率与其他社区样本相匹配。在下面 获得这个奖项，我将接受纵向建模创新方法的培训（即多层次和基于组的轨迹 建模）以生成在幼儿时期密集收集的数据模型，预测发育模式 学龄前儿童（3-5 岁）出现的多动症（ADHD）结果。根据公平的评估方法， 检查结构和家庭风险及保护因素的结构方程模型将更加丰富 描述学龄前儿童出现 ADHD 症状的途径。该项目旨在描述 在发育序列的最早阶段，神经发育对 ADHD 的脆弱性，建立了一个 以经验为基础的、公平的方法来评估和概念化早期风险。