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.

项目摘要 注意力缺陷/多动障碍（ADHD）是一种流行的和损害性的幼儿期疾病， 对规范发展提出了显著挑战，并且可以从学龄前年龄开始可靠地识别， 当采用基于发育的评估时，早在幼儿年龄就可以捕捉到风险。识别 注意力调节障碍的发展，在弗兰克障碍出现之前， 与急性ADHD综合征和损伤相关的级联反应。此外，最近的研究表明， 普遍的，早期发病的心理健康不平等，在紧急ADHD的模式中很明显， 公平评估以减少预测风险建模中的偏差（即，保护性因素会计 除风险外，还应模拟具体的风险指标，而不是将种族作为风险指标的代表）。因此电流 一个项目试图在注意力模式中描述发展变化及其社会人口背景 （dys）在幼儿期的监管与学龄前的结果。这项工作借鉴了新颖的，临床 可翻译的研究工具捕捉典型的：神经发育和行为的非典型谱 注意力指标调节：家长调查和标准化临床观察。项目 在第一次年度健康儿童访问时招募了一个以社区为基础的儿童样本， 对于精神病理学风险（即，易怒）。对以后时间点结果的初步检查表明， 样本的ADHD症状特征很好，患病率与其他社区样本相匹配。下 这个奖项，我将培训纵向建模的创新方法（即，多级分组轨迹 建模）以生成幼儿年龄时密集收集的数据模型，预测发育模式， 学龄前儿童（3-5岁）的ADHD紧急结果。按照公平的评估办法， 结构方程模型检查结构和家庭的风险和保护因素将更丰富 表征学龄前儿童出现ADHD症状的途径。该项目旨在描述 在发育序列的最早点，神经发育对ADHD的脆弱性，建立了一个 以经验为基础的公平方法评估和概念化早期风险。